Sentinel lymph node biopsy predicts outcomes for Merkel cell carcinoma
Patients with Merkel Cell Carcinoma who underwent a procedure called sentinel lymph node biopsy (SNLB) had a lower risk of cancer recurrence after two years, according to a study by researchers from Fox Chase Cancer Center. When the biopsy's results were used to guide subsequent tests and treatment, these patients had longer survival rates than patients who had not undergone the procedure.
"Sentinel lymph node biopsy, or SNLB, can be used to recommend which way to proceed with a patient's treatment," says Aruna Turaka, M.D., a radiation oncologist at Fox Chase and lead author on the new study. Turaka will present her team's findings at the 53rd Annual Meeting of the American Association for Radiation Oncology on Monday, October 3.
"Right now, with almost all patients, even stage I patients, we recommend radiation to the local site. But this study can help us make more judicious use of treatment and identify who will be most benefited to the regional lymph nodes," Turaka says.
Merkel cell carcinoma is a rare and aggressive type of skin cancer that forms in cells at the bottom of the epidermis, usually striking older people and people with weakened immune systems. The tumor often appears as a painless, fast-growing lump on a part of the body exposed to the sun, including the head and neck, the trunk, and legs and arms. The cancer is believed to metastasize from an early stage, first spreading to nearby regional lymph nodes. It may spread to other lymph nodes, as well as the lungs and other organs. The first lymph node where cancer cells appear is called the sentinel lymph node.
Because the disease metastasizes so quickly, Turaka says, it's important to identify the patients most at risk for a recurrence of cancer at or near the site of the original tumor. The new study may provide a way for practitioners to use sentinel lymph nodes to guide treatment and thereby reduce the likelihood of cancer returning to the same area. Patients diagnosed with Merkel Cell Carcinoma first undergo surgery to excise the primary tumor; most are then treated with radiation to the site.
In the last decade, sentinel lymph node biopsy has grown increasingly popular as a way to study and assess the extent of different types of cancer in the body. In an SLNB, the sentinel lymph node is identified, removed and studied. If cancerous cells are not detected, then the patient may avoid more follow-up surgery. If cancerous cells are detected, then the patient may have to undergo a lymph node dissection (LD), which is a more invasive procedure.
"Lymph node dissection is a definitely a big surgery," says Turaka, "and extensive surgery is always associated with high morbidity."
A patient with merkel cell carcinoma only receives further radiation if the SNLB comes back positive for cancer cells. If the biopsy is free of cancer cells, the patients is not given radiation and does not need to undergo surgery, says Turaka.
She and her colleagues studied the records of 88 patients from Fox Chase Cancer Center who were diagnosed with merkel cell carcinoma between 1990 and 2010. Of those, 41 had undergone SLNB. The researchers found that in 42 percent of patients whose SLNB turned up cancerous cells, cancer returned to same area within two years. Only 22 percent of patients with negative SLNB results had locoregional recurrences.
In addition, Turaka and her team found that patients who had undergone SLNB had higher two-year overall survival and disease-free survival rates compared to patients who had not undergone the surgery.
Provided by Fox Chase Cancer Center
- Sentinel node biopsy safe, effective in head and neck melanomas Aug 05, 2011 | not rated yet | 0
- Poorer breast cancer survival associated with micrometastases in axillary lymph nodes Feb 26, 2010 | not rated yet | 0
- 'Hidden' cancer cells not a factor in early-stage breast cancer survival rates Jul 26, 2011 | not rated yet | 0
- Routine breast cancer biopsy might predict lymph node cancer spread Apr 18, 2010 | not rated yet | 0
- Microbubble ultrasound and breast biopsies Feb 01, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer 52 minutes ago | not rated yet | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer 1 hour ago | not rated yet | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer 1 hour ago | 5 / 5 (1) | 0
A leading expert in childhood cancer at The University of Nottingham is spearheading a Europe-wide lobby of the European Parliament to try to make it easier for doctors to develop and test new treatments on children and young ...
Cancer 2 hours ago | not rated yet | 0
(AP)—Researchers examining the incidence of brain cancer at jet engine manufacturer Pratt & Whitney in Connecticut say they have found no statistically significant elevations in the rate of cancer among workers.
Cancer 3 hours ago | not rated yet | 0
(Medical Xpress)—A new study by researchers in the US has shown that an ancient virus can be modified to help in the fight against the simian immunodeficiency virus SIV, which is the equivalent in monkeys ...
1 hour ago | not rated yet | 0 |
How can healthy people who hear voices help schizophrenics? Finding the answer for this is at the centre of research conducted at the University of Bergen.
1 hour ago | 3 / 5 (1) | 0
New research presented today shows that formation of new neurons in the hippocampus - a brain region known for its importance in learning and remembering - could cause forgetting of old memories by causing a reorganization ...
42 minutes ago | not rated yet | 0
Ernie Pyle – an iconic war correspondent in World War II – reportedly said "There are no atheists in foxholes." A new joint study between two brothers at Cornell and Virginia Wesleyan found that only ...
45 minutes ago | not rated yet | 0
The individualisation of drug treatments to support patients to self-manage their conditions is a concept that sits at the heart of policy, but a recent study in BMJ Open shows that there is no concrete defini ...
1 hour ago | not rated yet | 0
Saudi Arabia said Friday it would send samples taken from animals possibly infected with a deadly SARS-like virus to the United States for testing in a bid to find the source of disease.
22 minutes ago | not rated yet | 0