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Dermatol Surg. 2002 Feb;28(2):113-7; discussion 117.

A meta-analysis of the prognostic significance of sentinel lymph node status in Merkel cell carcinoma.

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  • 1Department of Dermatology, Mayo Clinic, Rochester, Minnesota 55905, USA.



Merkel cell carcinoma is an aggressive cutaneous neoplasm with a high propensity to metastasize to lymph nodes.


The objective of this study was to determine the prognostic significance of sentinel lymph node status in patients with Merkel cell carcinoma.


A meta-analysis of case series of patients with Merkel cell carcinoma managed with sentinel lymph node biopsy was performed.


Forty of 60 patients (67%) had a biopsy-negative sentinel lymph node; 97% of this group had no recurrence at 7.3 months median follow-up. Twenty patients (33%) had a biopsy-positive sentinel lymph node; 33% of this group experienced local, regional, or systemic recurrence at 12 months median follow-up. Risk of recurrence or metastasis was 19-fold greater in biopsy-positive patients (odds ratio, 18.9; p = 0.005). None of 15 biopsy-positive patients who underwent therapeutic lymph node dissection experienced a regional recurrence; 3 of 4 who did not receive therapeutic lymphadenectomy experienced regional recurrence.


Sentinel lymph node positivity is strongly predictive of a high short-term risk of recurrence or metastasis in patients with Merkel cell carcinoma. Therapeutic lymph node dissection appears effective in preventing short-term regional nodal recurrence. Aggressive adjuvant treatment should be considered for patients with positive sentinel lymph nodes.

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