Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 168
Filtrar
1.
J Pak Med Assoc ; 69(11): 1693-1699, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31740881

RESUMO

Merkel cell carcinoma is an aggressive non-melanomatous cutaneous tumour of neuroendocrine origin with an increasing incidence in the recent years. It is a tumour of the elderly and immunosuppressed, which most often appears on sun-exposed areas of the body. The clinical features of the cutaneous or subcutaneous lesions hardly contribute to the diagnosis, and, hence, histopathology and immunohistochemistry play a vital role in diagnosis. The latest staging system by the American Joint Committee on Cancer includes non-nodal invasion to adjacent structures i.e. bone, muscle, fascia, or cartilage into the criteria, in additionto size and depth of invasion. The management reliesheavily on a multidisciplinary approach due to rarity of incidence of this disease. According to the international guidelines, surgical management is still the preferred choice. The beneficial role of adjuvant radiotherapy has now been more clearly documented. Data is insufficient to assess whether chemotherapy improves disease-free or overall survival.


Assuntos
Carcinoma de Célula de Merkel/terapia , Neoplasias Cutâneas/terapia , Carcinoma de Célula de Merkel/diagnóstico , Carcinoma de Célula de Merkel/epidemiologia , Humanos , Radioterapia Adjuvante , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia
4.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(5): 360-365, jun. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-180924

RESUMO

Introducción: El carcinoma de células de Merkel (CCM) es un tumor cutáneo muy agresivo y de mal pronóstico, aunque la incidencia es muy baja. Existen pocas series que analicen la experiencia en un mismo centro. Metodología: Estudio observacional, descriptivo y retrospectivo de todos los pacientes diagnosticados en un hospital de tercer nivel entre 2002 y 2017. Se recogieron las características epidemiológicas, clínicas, histológicas, el tratamiento y la supervivencia, y se dividió la muestra en 2 períodos para el análisis (2002-2009 y 2010-2017). Se realizó un análisis de supervivencia mediante el modelo de Kaplan-Meier y un análisis multivariante mediante el modelo de riesgos proporcionales de Cox. Resultados: Se incluyó a 38 pacientes, 24 hombres y 14 mujeres, con una edad media 77,76 años. El período medio de seguimiento fue de 30,11 meses. Se observó un aumento del 116% (12 vs. 26) entre los años 2002-2009 y 2010-2017, así como una edad media más avanzada (70,92 vs. 80,92; p < 0,05) y un incremento de lesiones en tronco y miembros inferiores (34,62% vs. 0%). Once pacientes fallecieron debido al CCM. La supervivencia global a los 12 meses en la serie fue del 78,2% y a los 24 meses del 69,3%. Los factores asociados a mortalidad fueron la edad mayor de 70 años y la afectación ganglionar, mientras que la localización en miembros superiores y la realización de ampliación de márgenes aumentó la supervivencia. Al realizar el análisis multivariante, solo la afectación de ganglios permaneció como factor pronóstico. Conclusiones: Se ha observado un aumento de la frecuencia en los últimos años y un cambio en la forma de presentación a edades más avanzadas y en otras localizaciones diferentes a las clásicas


Background: Merkel cell carcinoma is a rare yet aggressive cutaneous tumor with a poor prognosis. Few studies have analyzed series of patients from the same hospital. Methodology: We performed a retrospective, descriptive, observational study of all patients diagnosed with Merkel cell carcinoma at a tertiary care hospital between 2002 and 2017. We recorded epidemiological, clinical, and histologic data and information on treatments and survival. For analysis, the sample was divided into 2 groups from different periods: 2002-2009 and 2010-2017. We performed survival analysis using Kaplan-Meier curves and multivariate analysis using a Cox proportional hazards model. Results: Thirty-eight patients (24 men and 14 women) with a mean age of 77.76 years were included. Mean follow-up time was 30.11 months. On comparing 2010-2017 with 2002-2009, we observed a 116% increase in the number of Merkel cell carcinoma cases (26 vs. 12), an older mean age at diagnosis (80.92 vs. 70.92 years, P<.05), and an increase in lesions located on the trunk and lower limbs (0% vs. 34.62%). Eleven patients died of Merkel cell carcinoma. Overall survival was 78.2% at 12 months and 69.3% at 24 months. In the univariate analysis, age over 70 years and lymph node involvement were associated with mortality, while tumor location on the upper extremities and wide surgical excision were associated with improved survival. Only lymph node involvement retained its prognostic significance in the multivariate analysis. Conclusions: In this series, we observed that Merkel cell carcinoma has become more common in recent years and is now diagnosed at an older age and found in new anatomic locations


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Célula de Merkel/epidemiologia , Estimativa de Kaplan-Meier , Carcinoma de Célula de Merkel/diagnóstico , Epidemiologia Descritiva , Estudos Retrospectivos , Estudo Observacional , Carcinoma de Célula de Merkel/mortalidade , Análise Multivariada , Prognóstico , Antineoplásicos/uso terapêutico
5.
Australas J Dermatol ; 60(4): e284-e291, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30900248

RESUMO

BACKGROUND/OBJECTIVES: Merkel cell carcinoma is an aggressive neuroendocrine skin cancer. Australian studies report high incidence and poor survival rates compared internationally. While New Zealand has a comparable UV index and racial composition to Australia, survival outcomes are currently unknown. The role of Merkel cell polyoma virus in oncogenesis of Merkel cell carcinoma is an active area of research. We describe the incidence and survival of Merkel cell carcinoma in New Zealand with correlation to demographic and clinical factors including regional polyoma virus prevalence. METHODS: Retrospective study of population-based data from the New Zealand Cancer Registry. Incidence rates were directly standardised to the US standard 2000 population. Survival was investigated using Kaplan-Meier and multivariable Cox regression models. RESULTS: Six hundred and one cases were diagnosed in New Zealand between 2000 and 2015. The overall incidence rate was 0.96/100 000 population. Merkel cell carcinoma is more common in males, elderly and on sun-exposed areas. Eighteen percent of patients were diagnosed with distant metastasis at time of presentation. The overall 5-year survival rate and relative 5-year survival rate were 31% and 45%, respectively. Mortality was 1.9 and 2.5 times higher for stage III and IV disease, respectively, relative to stage I/II disease. Patients over age 80 had twice the mortality compared to those aged 60-69. CONCLUSIONS: New Zealand has a high incidence of Merkel cell carcinoma and poor survival outcomes when compared internationally. We have the highest proportion of distant metastatic disease at time of diagnosis. Further research into the role of nonpolyoma-related Merkel cell carcinoma is warranted to improve Merkel cell carcinoma outcomes in New Zealand and abroad.


Assuntos
Carcinoma de Célula de Merkel/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Célula de Merkel/patologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Nova Zelândia/epidemiologia , Sistema de Registros , Estudos Retrospectivos , Distribuição por Sexo , Neoplasias Cutâneas/patologia , Taxa de Sobrevida , Estados Unidos/epidemiologia , Adulto Jovem
8.
J Am Acad Dermatol ; 81(4): 977-983, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30703452

RESUMO

BACKGROUND: Merkel cell carcinoma (MCC) is a rare and potentially lethal skin cancer. MCC is known for its potential rapid growth and its propensity to metastasize. OBJECTIVE: To describe the incidence, treatment, and survival of MCC in a population-based setting. METHODS: All MCCs diagnosed in The Netherlands between 1993 and 2016 were selected from the Netherlands Cancer Registry. Patient and tumor characteristics, therapy, and vital status were obtained. Cox proportional hazards were computed, and relative survival analyses were performed. RESULTS: Our cohort included 1977 patients with MCC. Incidence increased from 0.17 per 100,000 person-years in 1993 to 0.59 per 100,000 in 2016. The mean age at diagnosis was 75.5. Most MCCs (59.8%) were treated with surgery alone. Relative 5-year survival was low (63.0%) and did not improve. Mortality was higher among males (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.11-1.39), higher age (HR, 1.07; 95% CI, 1.06-1.07), and nodal (HR, 1.26; 95% CI, 1.08-1.48) and distant spread of disease (HR, 2.44; 95% CI, 1.99-2.99). LIMITATIONS: We lacked data on cause of death, comorbidity, and pathologic margins, which may have led to misinterpretation of the data. CONCLUSION: This study shows continuously increasing incidence rates of MCC in The Netherlands. Survival after a diagnosis of MCC remained low. Our results emphasize the need for implementation of new therapies.


Assuntos
Carcinoma de Célula de Merkel/epidemiologia , Carcinoma de Célula de Merkel/secundário , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Célula de Merkel/mortalidade , Carcinoma de Célula de Merkel/terapia , Feminino , Humanos , Incidência , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Modelos de Riscos Proporcionais , Sistema de Registros , Fatores Sexuais , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/terapia , Taxa de Sobrevida
9.
Int J Dermatol ; 58(6): 703-706, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30620056

RESUMO

BACKGROUND: Merkel cell carcinoma (MCC) is a rare but aggressive primary cutaneous carcinoma with high mortality rates. The present study intends to delineate the epidemiological profile of patients with MCC seen at the Clinics Hospital of the Medical School at the University of São Paulo, Brazil, and its association with Merkel cell polyomavirus (MCPyV). METHODS: This is a retrospective study. A search was performed in the hospital's medical index for all cases of MCC from January 1994 to December 2012. Among patients with MCC, the available tumoral skin specimens were analyzed with two different techniques of polymerase chain reaction (PCR) (conventional and real-time) for detection of MCPyV DNA. Additionally, paraffin-embedded samples of patients with non-MCC skin cancers were also analyzed. Analyses suitable for categorical data (i.e., x² of Fisher) were used to compare the proportion of patients in each group. RESULTS: Nineteen patients with MCC and 20 patients with non-MCC skin cancers entered the study. All MCC samples available (13) tested positive for the presence of MCPyV DNA; however, in the non-MCC skin cancer samples, the MCPyV DNA was detected in 4 of 20 samples (20%). MCPyV DNA detection rate was higher in patients with MCC than in the other group, and its analysis was statistically significant (P < 0.01). CONCLUSIONS: This study demonstrates the association of MCPyV in Brazilian patients with MCC. However, further studies are necessary to determine the exact involvement of MCPyV in MCC pathogenesis and to define the significance of viral DNA detection in non-MCC skin cancers.


Assuntos
Carcinoma de Célula de Merkel/virologia , Poliomavírus das Células de Merkel/isolamento & purificação , Infecções por Polyomavirus/virologia , Neoplasias Cutâneas/virologia , Infecções Tumorais por Vírus/virologia , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Carcinoma de Célula de Merkel/epidemiologia , DNA Viral/isolamento & purificação , Feminino , Humanos , Masculino , Poliomavírus das Células de Merkel/genética , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Infecções por Polyomavirus/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores Sexuais , Pele/virologia , Neoplasias Cutâneas/epidemiologia , Infecções Tumorais por Vírus/epidemiologia
10.
Hematol Oncol Clin North Am ; 33(1): 39-52, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30497676

RESUMO

Merkel cell carcinoma is a rare and aggressive cutaneous malignancy of neuroendocrine origin-an often-missed diagnosis due to the wide histopathologic differential diagnosis of malignant small blue cell tumors. The advent of electron microscopy and immunohistochemistry staining for cytokeratin 20, a shared neuroendocrine marker, greatly improved diagnostic accuracy. Over the past decade, staging, treatment, and surveillance of the cancer have progressed at a remarkably rapid pace. Herein, the authors provide an update on the current guidelines around diagnosis and management and review the exciting advancements on the horizon.


Assuntos
Carcinoma de Célula de Merkel/diagnóstico , Carcinoma de Célula de Merkel/terapia , Biomarcadores Tumorais , Carcinoma de Célula de Merkel/epidemiologia , Carcinoma de Célula de Merkel/etiologia , Terapia Combinada , Diagnóstico Diferencial , Gerenciamento Clínico , Suscetibilidade a Doenças , Humanos , Estadiamento de Neoplasias , Avaliação de Resultados em Cuidados de Saúde , Fenótipo , Prognóstico , Vigilância em Saúde Pública , Avaliação de Sintomas
11.
J Am Acad Dermatol ; 80(2): 460-465.e9, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29913261

RESUMO

BACKGROUND: Hydrochlorothiazide use has been associated with markedly increased risk for squamous cell carcinoma. No previous studies have investigated the association between hydrochlorothiazide use and the risk for Merkel cell carcinoma (MCC) and malignant adnexal skin tumors (MAST). OBJECTIVE: To examine the association between hydrochlorothiazide use and the risk for MCC and MAST. METHODS: Using Danish nationwide health registries, we identified all patients with incident MCC or MAST during 2004-2015 and matched the cases individually to cancer-free population controls by risk set sampling. Using conditional logistic regression, we estimated the odds ratios (ORs) and confidence intervals (CIs) associated with cumulative use of hydrochlorothiazide. RESULTS: The adjusted ORs for MCC and MAST associated with high use (≥50,000 mg) of hydrochlorothiazide was 2.3 (95% CI 1.1-4.8) and 3.6 (95% CI 1.9-7.0), respectively, which increased to 3.3 (95% CI 1.3-8.3) and 5.6 (95% CI 2.4-13.3), respectively, with highest use (≥100,000 mg). We found no increased risk for these tumors in analyses of drugs with similar indications as hydrochlorothiazide, except there was a tendency toward an increased risk for MCC associated with the use of furosemide (OR 1.9, 95% CI 0.9-4.0). LIMITATIONS: No data on sun exposure was available. CONCLUSION: Hydrochlorothiazide use is associated with an increased risk for MCC and MAST.


Assuntos
Carcinoma de Célula de Merkel/induzido quimicamente , Hidroclorotiazida/efeitos adversos , Neoplasias de Anexos e de Apêndices Cutâneos/induzido quimicamente , Sistema de Registros , Neoplasias Cutâneas/induzido quimicamente , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Célula de Merkel/epidemiologia , Carcinoma de Célula de Merkel/patologia , Estudos de Casos e Controles , Dinamarca , Relação Dose-Resposta a Droga , Feminino , Humanos , Hidroclorotiazida/uso terapêutico , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias de Anexos e de Apêndices Cutâneos/epidemiologia , Neoplasias de Anexos e de Apêndices Cutâneos/patologia , Razão de Chances , Prognóstico , Estudos Retrospectivos , Medição de Risco , Distribuição por Sexo , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Análise de Sobrevida
13.
Int J Cancer ; 144(4): 741-745, 2019 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-30194728

RESUMO

Merkel Cell Carcinoma (MCC) is an aggressive skin cancer with an increasing incidence. Population-based epidemiologic data about MCC in France are rare. Our study aims to describe the epidemiology of MCC in Bas-Rhin, Northeastern of France, between 1985 and 2013. Data were collected from the Bas-Rhin Cancer Registry. We measured age-adjusted incidence rates (per 100,000 person-years) and effect of age, sex and period of diagnosis on survival. The world age-standardized incidence rate was 0.17 and it quadrupled between 1985 and 2013. Cases (n = 111) occurred mostly in women (60%) and in persons ≥70 years of age (74%). Incidence rates was close for men (0.18) and women (0.16) and was 25-time higher in people ≥70 years of age but incidence rate similarly increased between 1985 and 2013 in persons older and younger than 70 years. Net 5-year survival was 48.5%; female sex and younger age were positive predictors of survival. Given the low number of cases, incidence and survival data should be interpreted with caution. Incidence of MCC in Bas-Rhin quadrupled between 1985 and 2013. The highest incidence rate was observed in people ≥70 years. Better survival was associated with female sex and younger age. We hypothesize that MCC will still increase and be diagnosed in increasingly younger patients in next generations.


Assuntos
Carcinoma de Célula de Merkel/epidemiologia , Vigilância da População/métodos , Sistema de Registros/estatística & dados numéricos , Neoplasias Cutâneas/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , França/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
14.
Actas Dermosifiliogr ; 110(5): 360-365, 2019 Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30376954

RESUMO

BACKGROUND: Merkel cell carcinoma is a rare yet aggressive cutaneous tumor with a poor prognosis. Few studies have analyzed series of patients from the same hospital. METHODOLOGY: We performed a retrospective, descriptive, observational study of all patients diagnosed with Merkel cell carcinoma at a tertiary care hospital between 2002 and 2017. We recorded epidemiological, clinical, and histologic data and information on treatments and survival. For analysis, the sample was divided into 2 groups from different periods: 2002-2009 and 2010-2017. We performed survival analysis using Kaplan-Meier curves and multivariate analysis using a Cox proportional hazards model. RESULTS: Thirty-eight patients (24 men and 14 women) with a mean age of 77.76 years were included. Mean follow-up time was 30.11 months. On comparing 2010-2017 with 2002-2009, we observed a 116% increase in the number of Merkel cell carcinoma cases (26 vs. 12), an older mean age at diagnosis (80.92 vs. 70.92 years, P<.05), and an increase in lesions located on the trunk and lower limbs (0% vs. 34.62%). Eleven patients died of Merkel cell carcinoma. Overall survival was 78.2% at 12 months and 69.3% at 24 months. In the univariate analysis, age over 70 years and lymph node involvement were associated with mortality, while tumor location on the upper extremities and wide surgical excision were associated with improved survival. Only lymph node involvement retained its prognostic significance in the multivariate analysis. CONCLUSIONS: In this series, we observed that Merkel cell carcinoma has become more common in recent years and is now diagnosed at an older age and found in new anatomic locations.


Assuntos
Carcinoma de Célula de Merkel/diagnóstico , Carcinoma de Célula de Merkel/epidemiologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
15.
Ann Dermatol Venereol ; 145 Suppl 7: VIIS40-VIIS46, 2018 Dec.
Artigo em Francês | MEDLINE | ID: mdl-30583756

RESUMO

This year again, several breaking news were published in our field of oncodermatology, especially in the domain of immunotherapy. Many works have reported results on predictive biomarker identification. Concerning melanoma treatment, we were disappointed by the negative results of the phase III trial evaluating the IDO1 inhibitor epacadostat + pembrolizumab versus pembrolizumab. However, many promising preliminary results involving the combinations of anti-PD1 and innate immunity activators have been published. We also have a new anti-BRAF + anti-MEK combination: encorafenib + binimetinib with a good benefit/risk ratio and a particularly favorable safety profile as compared with existing similar combinations. Major steps forward were obtained for locally advanced Merkel cell carcinoma and squamous cell carcinoma with anti-PDL-1 avelumab and anti-PD1 cemiplimab respectively.


Assuntos
Neoplasias Cutâneas/tratamento farmacológico , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Antineoplásicos Imunológicos/uso terapêutico , Benzimidazóis/uso terapêutico , Biomarcadores Tumorais/metabolismo , Carbamatos/uso terapêutico , Carcinoma de Célula de Merkel/tratamento farmacológico , Carcinoma de Célula de Merkel/epidemiologia , Carcinoma de Célula de Merkel/metabolismo , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/metabolismo , Ensaios Clínicos como Assunto , Dermatologia/tendências , Humanos , Melanoma/tratamento farmacológico , Melanoma/metabolismo , Neoplasias Cutâneas/metabolismo , Sulfonamidas/uso terapêutico , Análise de Sobrevida
18.
J Natl Compr Canc Netw ; 16(6): 742-774, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29891526

RESUMO

This selection from the NCCN Guidelines for Merkel Cell Carcinoma (MCC) focuses on areas impacted by recently emerging data, including sections describing MCC risk factors, diagnosis, workup, follow-up, and management of advanced disease with radiation and systemic therapy. Included in these sections are discussion of the new recommendations for use of Merkel cell polyomavirus as a biomarker and new recommendations for use of checkpoint immunotherapies to treat metastatic or unresectable disease. The next update of the complete version of the NCCN Guidelines for MCC will include more detailed information about elements of pathology and addresses additional aspects of management of MCC, including surgical management of the primary tumor and draining nodal basin, radiation therapy as primary treatment, and management of recurrence.


Assuntos
Carcinoma de Célula de Merkel/terapia , Oncologia/normas , Poliomavírus das Células de Merkel/isolamento & purificação , Neoplasias Cutâneas/terapia , Assistência ao Convalescente/normas , Carcinoma de Célula de Merkel/diagnóstico , Carcinoma de Célula de Merkel/epidemiologia , Carcinoma de Célula de Merkel/virologia , Quimiorradioterapia/métodos , Quimiorradioterapia/normas , Humanos , Incidência , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/virologia , Sociedades Médicas/normas , Estados Unidos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA