|
| Institute | Number of patients/important features | Important results/conclusions |
|
| Memorial Sloan-Kettering Cancer Center, New York, US. Allen et al. [16] | 109
retrospective | (i) Overall DSS after recurrence was 62%
(ii) Predictors of improved DSS after recurrence
included
(a) nodal as compared to local or distant recurrence
(b) the ability to render the patient free of disease
after recurrence
(c) DFI > 8 m |
|
| Princess Margaret Hospital, Canada; Royal Prince Alfred Hospital & Westmead Hospital, Sydney, Australia. Clark et al. [17] | 110
retrospective | Predictors of survival on MVA:
(i) age > 70 years (HR 6.19, P < 0.001),
(ii) primary tumor size > 1 cm (HR 7.55, P < 0.001),
(iii) number of nodal metastases divided into none, ≤ 2 & >2 (HR 3.71 per stratum, P < 0.001)
(iv) stage II disease derives the greatest benefit from adjuvant RT, including improved DSS |
|
| Surveillance Epidemiology, and End Results database. Mojica et al. [18] | 1665
Retrospective registry | (i) MS for those with and without adjuvant RT: 63 versus 45 m
(ii) RT improves survival for patients with all sizes of tumors, particularly when primary lesions are larger than 2 cm |
|
| University of Saskatchewan. Tai et al. [19] | 433
retrospective, combined with the literature cases | (i) Nodal metastases occurred clinically at presentation in 9/105 (9%) patients with primary tumor size 1 cm or less—too high to obviate SLNB even for small tumors |
|
| Peter MacCallum Cancer Centre. Hui et al. [20] | 176
retrospective | (i) Median interval to recurrence was 8 m
(ii) DM developed in 43 patients (24%)
(iii) Age, primary tumor size, and RT (no RT versus <45 Gy versus ≥45 Gy) were predictive of locoregional control on univariate analysis
However, only RT remained significant on MVA |
|
| Memorial Sloan-Kettering Cancer Center, New York, US. Fields et al. [21] | 500
prospective database | (i) 50% patients died during followup: 25% died of disease, 24% died of other causes
(ii) 5-year OS and CSS were 56% and 30%, respectively
(iii) Only 1 of 132 patients without LVI died of MCC |
|
| University of Bern, Switzerland. Ghadjar et al. [22] | 180
retrospective | (i) RT group compared to surgery to primary tumor alone:
LRFS (93% versus 64%; P < 0.001),
RRFS (76% versus 27%; P < 0.001),
DMFS (70% versus 42%; P = 0.01),
DFS (59% versus 4%; P < 0.001),
CSS (65% versus 49%; P = 0.03)
(ii) LRFS, RRFS, DMFS, and DFS are s.s. on MVA. |
|
| Helsinki University Central Hospital, Norway. Kukko et al. [5] | 181
retrospective | (i) No extra benefit was gained from a wide surgical margin (≥2 cm) compared to a margin of 1–1.9 cm, but an intralesional excision was more often associated with LR |
|
| Memorial Sloan-Kettering Cancer Center, New York, US. Fields et al. [23] | 364
prospective database | (i) 30% developed a recurrence: 3% local, 3% in-transit, 12% nodal, 12% distant
(ii) A low recurrence rate in patients with clinically node-negative MCC was achieved with adequate surgery (including SLNB) and the selective use of adjuvant RT for high-risk tumors |
|
| Mayo Clinic, US. Grotz et al. [24] | 240
retrospective | (i) 10.4% local, 7.5% in-transit, 11.3% nodal recurrences
(ii) LRR is a poor prognostic sign, with a 3-year OS of 39%, but still warrants aggressive treatment |
|
