Carcinoma de células de Merkel. Estudio observacional retrospectivo (1998-2018) del Hospital Universitario Basurto

Abstract

espanolIntroduccion: El carcinoma de celulas de Merkel (CCM) es una neoplasia cutanea infrecuente y de pronostico pobre. No hay consenso para abordar su manejo. Material y metodos: Realiza-mos una busqueda de pacientes con diagnostico histologico de CCM entre 1998 y 2018 (n = 20), en la base de datos de nuestro hospital. Recogimos las siguientes variables: sexo, edad, historia de inmunosupresion y de cancer cutaneo no melanoma y me-lanoma maligno, sospecha diagnostica inicial, tamano tumoral, localizacion, estadificacion, tratamientos recibidos, evolucion y supervivencia. Resultados: La mayoria de las lesiones (40%) se localizaban en la cabeza y cuello, y 50% tenian un tamano de 2 a 5 cm. Ochenta y cinco por ciento de los pacientes recibio tratamiento quirurgico y 75% radioterapia. Cincuenta por ciento de los pacientes presentaron recidivas, todas en los primeros dos anos. Hemos observado que la supervivencia es mayor en los pacientes con lesiones menores de 2 cm, localizadas en extremidades, con positividad para poliomavirus, en los que recibieron radioterapia adyuvante y no presentan margenes quirurgicos afectados. Conclusiones: Hemos identificado cinco factores asociados con una mayor supervivencia que, aunque no son estadisticamente significativos (por el tamano muestral), son clinicamente relevantes y coinciden con los de otras series. EnglishIntroduction: Merkel cell carcinoma (MCC) is a rare cutaneous neoplasm with a poor prognosis. There is no consensus to address its management. Material and methods: We performed a search of patients with histological diagnosis of MCC from 1998 to 2018 (n = 20), in the database of our hospital and we collected next data: sex, age, history of immunosuppression, skin cancer no melanoma and malignant melanoma, initial diagnosis suspicion, tumor size, location, staging, treatments received, evolution and survival. Results:The majority of lesions (40%) were located in the face and neck and 50% had 2 to 5 cm. 85% of the patients received surgical treatment, 75% had RT. 50% of patients had recurrence, all before the first 24 months. In our sample, we observed that survival is greater in patients with lesions smaller than 2 cm, located in extremities, positive for polyomavirus, in those who have received adjuvant RT and in those without affected surgical. Conclusions: We have observed five factors associated with grater survival, which, although not statistically significant, are clinically relevant and concur with those of other series