Merkel cell carcinoma: Report of ten cases with emphasis on clinical course, treatment, and in vitro drug sensitivity
Identifieur interne : 00BA59 ( Main/Exploration ); précédent : 00BA58; suivant : 00BA60Merkel cell carcinoma: Report of ten cases with emphasis on clinical course, treatment, and in vitro drug sensitivity
Auteurs : Konstantin Krasagakis [Allemagne] ; Brigitte Almond-Roesler [Allemagne] ; Christos C. Zouboulis [Allemagne] ; Beate Tebbe [Allemagne] ; Elke Wartenberg [Allemagne] ; Klaus-Dietrich Wolff [Allemagne] ; Constantin E. Orfanos [Allemagne]Source :
- Journal of the American Academy of Dermatology [ 0190-9622 ] ; 1997.
Abstract
Background:Merkel cell carcinoma (MCC) is an uncommon primary neuroendocrine skin tumor most often seen in the elderly. The clinical course varies. Treatment is controversial and few data on drug sensitivity are available.Objective:We evaluated the clinical course and treatment of 10 MCC patients and determined MCC chemosensitivity.Methods:Clinical records as well as laboratory and histopathologic data from 10 patients with MCC treated in our department were examined. Chemosensitivity to various chemotherapeutic agents and interferons of MCC cells from four patients was determined in a soft agar clonogenic assay.Results:MCC behaved as an aggressive tumor with early and frequent local relapses (4 of 10 patients at a 2.2-month average), regional (4 of 10 patients at 2.5 months), and distant metastases (5 of 10 patients 9.6 months after excision of the primary tumor). In all but one patient, regional metastases preceded distant ones. Metastatic spread was associated with an average survival of 21 months from the initial diagnosis. Long-term survival (53+ and 65+ months) was observed in two women. Wide excision of the primary tumor, alone or combined with adjuvant chemotherapy and radiotherapy, was the most effective treatment. In advanced disease, chemotherapy and radiotherapy were not able to induce long-term remission. In vitro assays for MCC drug sensitivity revealed cisplatin, doxorubicin, and vindesine to be the most active.Conclusion:MCC has a poor prognosis in advanced stages; therefore the primary tumor should be aggressively treated. The in vitro clonogenic assay may help to identify the chemosensitivity profile of MCC and to optimize chemotherapy protocols.
Url:
DOI: 10.1016/S0190-9622(97)80325-8
Affiliations:
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Orfanos</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B663128280E0EF66A9BEFF3FE4CD1B5311638E8D</idno><date when="1997" year="1997">1997</date><idno type="doi">10.1016/S0190-9622(97)80325-8</idno><idno type="url">https://api.istex.fr/document/B663128280E0EF66A9BEFF3FE4CD1B5311638E8D/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">005566</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">005566</idno><idno type="wicri:Area/Istex/Curation">005566</idno><idno type="wicri:Area/Istex/Checkpoint">004012</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">004012</idno><idno type="wicri:doubleKey">0190-9622:1997:Krasagakis K:merkel:cell:carcinoma</idno><idno type="wicri:Area/Main/Merge">00C232</idno><idno type="wicri:Area/Main/Curation">00BA59</idno><idno type="wicri:Area/Main/Exploration">00BA59</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Merkel cell carcinoma: Report of ten cases with emphasis on clinical course, treatment, and in vitro drug sensitivity</title><author><name sortKey="Krasagakis, Konstantin" sort="Krasagakis, Konstantin" uniqKey="Krasagakis K" first="Konstantin" last="Krasagakis">Konstantin Krasagakis</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology, University Medical Center Benjamin Franklin, The Free University of Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Reprint requests: Konstantin Krasagakis, MD, Department of Dermatology, University Medical Center Benjamin Franklin, The Free University of Berlin, Hindenburgdauun 30, 12200 Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Almond Roesler, Brigitte" sort="Almond Roesler, Brigitte" uniqKey="Almond Roesler B" first="Brigitte" last="Almond-Roesler">Brigitte Almond-Roesler</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology, University Medical Center Benjamin Franklin, The Free University of Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Zouboulis, Christos C" sort="Zouboulis, Christos C" uniqKey="Zouboulis C" first="Christos C." last="Zouboulis">Christos C. Zouboulis</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology, University Medical Center Benjamin Franklin, The Free University of Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Tebbe, Beate" sort="Tebbe, Beate" uniqKey="Tebbe B" first="Beate" last="Tebbe">Beate Tebbe</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology, University Medical Center Benjamin Franklin, The Free University of Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Wartenberg, Elke" sort="Wartenberg, Elke" uniqKey="Wartenberg E" first="Elke" last="Wartenberg">Elke Wartenberg</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Maxillofacial and Plastic Surgery, University Medical Center Benjamin Franklin, The Free University of Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Wolff, Klaus Dietrich" sort="Wolff, Klaus Dietrich" uniqKey="Wolff K" first="Klaus-Dietrich" last="Wolff">Klaus-Dietrich Wolff</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Maxillofacial and Plastic Surgery, University Medical Center Benjamin Franklin, The Free University of Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Orfanos, Constantin E" sort="Orfanos, Constantin E" uniqKey="Orfanos C" first="Constantin E." last="Orfanos">Constantin E. Orfanos</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology, University Medical Center Benjamin Franklin, The Free University of Berlin, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of the American Academy of Dermatology</title><title level="j" type="abbrev">YMJD</title><idno type="ISSN">0190-9622</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1997">1997</date><biblScope unit="volume">36</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="727">727</biblScope><biblScope unit="page" to="732">732</biblScope></imprint><idno type="ISSN">0190-9622</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0190-9622</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background:Merkel cell carcinoma (MCC) is an uncommon primary neuroendocrine skin tumor most often seen in the elderly. The clinical course varies. Treatment is controversial and few data on drug sensitivity are available.Objective:We evaluated the clinical course and treatment of 10 MCC patients and determined MCC chemosensitivity.Methods:Clinical records as well as laboratory and histopathologic data from 10 patients with MCC treated in our department were examined. Chemosensitivity to various chemotherapeutic agents and interferons of MCC cells from four patients was determined in a soft agar clonogenic assay.Results:MCC behaved as an aggressive tumor with early and frequent local relapses (4 of 10 patients at a 2.2-month average), regional (4 of 10 patients at 2.5 months), and distant metastases (5 of 10 patients 9.6 months after excision of the primary tumor). In all but one patient, regional metastases preceded distant ones. Metastatic spread was associated with an average survival of 21 months from the initial diagnosis. Long-term survival (53+ and 65+ months) was observed in two women. Wide excision of the primary tumor, alone or combined with adjuvant chemotherapy and radiotherapy, was the most effective treatment. In advanced disease, chemotherapy and radiotherapy were not able to induce long-term remission. In vitro assays for MCC drug sensitivity revealed cisplatin, doxorubicin, and vindesine to be the most active.Conclusion:MCC has a poor prognosis in advanced stages; therefore the primary tumor should be aggressively treated. The in vitro clonogenic assay may help to identify the chemosensitivity profile of MCC and to optimize chemotherapy protocols.</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Berlin</li></region><settlement><li>Berlin</li></settlement></list><tree><country name="Allemagne"><region name="Berlin"><name sortKey="Krasagakis, Konstantin" sort="Krasagakis, Konstantin" uniqKey="Krasagakis K" first="Konstantin" last="Krasagakis">Konstantin Krasagakis</name></region><name sortKey="Almond Roesler, Brigitte" sort="Almond Roesler, Brigitte" uniqKey="Almond Roesler B" first="Brigitte" last="Almond-Roesler">Brigitte Almond-Roesler</name><name sortKey="Krasagakis, Konstantin" sort="Krasagakis, Konstantin" uniqKey="Krasagakis K" first="Konstantin" last="Krasagakis">Konstantin Krasagakis</name><name sortKey="Orfanos, Constantin E" sort="Orfanos, Constantin E" uniqKey="Orfanos C" first="Constantin E." last="Orfanos">Constantin E. Orfanos</name><name sortKey="Tebbe, Beate" sort="Tebbe, Beate" uniqKey="Tebbe B" first="Beate" last="Tebbe">Beate Tebbe</name><name sortKey="Wartenberg, Elke" sort="Wartenberg, Elke" uniqKey="Wartenberg E" first="Elke" last="Wartenberg">Elke Wartenberg</name><name sortKey="Wolff, Klaus Dietrich" sort="Wolff, Klaus Dietrich" uniqKey="Wolff K" first="Klaus-Dietrich" last="Wolff">Klaus-Dietrich Wolff</name><name sortKey="Zouboulis, Christos C" sort="Zouboulis, Christos C" uniqKey="Zouboulis C" first="Christos C." last="Zouboulis">Christos C. Zouboulis</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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