Management and Prognosis of Cardiac Metastatic Merkel Cell Carcinoma: A Case-Control Study and Literature Review.
Management and Prognosis of Cardiac Metastatic Merkel Cell Carcinoma: A Case-Control Study and Literature Review.
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大约20%的默克尔细胞癌（MCC）患者会发生远处转移。很少，MCC转移可能涉及心脏，有有限的数据管理和MCC的心脏转移的预后。在582例转移性MCC（mMCC）患者的前瞻性登记研究中，我们确定了9例（1.5%）心脏受累患者。我们发现心脏mMCC最常累及右心（89; 89%），并且在疾病过程中发生相对较晚（从最初诊断到心脏受累的平均时间为925天）。在我们的队列中，心脏mMCC经常对免疫治疗和心脏放疗有反应，这两种治疗都可以以最小的心脏毒性进行。与非心脏远端疾病的MCC患者相比，心脏受累与生存率降低无关。这些结果是及时的，因为随着转移性MCC患者的寿命延长，在免疫治疗时代，心脏mMCC可能会越来越多地出现。默克尔细胞癌（MCC）是一种侵袭性神经内分泌皮肤癌，具有很高的远处转移率（20%）。在2003-2021年诊断的582例转移性MCC（mMCC）患者的前瞻性登记研究中，我们确定了9例（1.5%）发生心脏转移性MCC（mMCC）的患者。我们在一项匹配的病例对照研究中比较了心脏和非心脏转移患者的总生存期（OS）。心脏转移是一种晚期事件（距离首次MCC诊断的中位时间为925天）。主要累及右心（89; 89%）。在7例接受免疫治疗的患者中，6例心脏病变获得完全或部分缓解。在这6例缓解者中，5例接受了免疫治疗的同时心脏放疗（中位数20 Gray）; 5例中的4例在治疗的心脏病变中没有局部疾病进展或复发。1年OS为44%，与非心源性mMCC患者（45%，p = 0.96）无显著差异。虽然它发生在疾病过程中相对较晚，但心脏mMCC对免疫治疗和/或放疗有反应，与其他解剖部位的mMCC相比，与预后不良无关。这些结果是及时的，因为随着转移性MCC患者的寿命延长，在免疫治疗时代可能会越来越多地遇到心脏mMCC。
Approximately 20% of patients with Merkel cell carcinoma (MCC) will develop distant metastasis. Rarely, MCC metastases may involve the heart; there are limited data on management and prognosis of cardiac metastasis of MCC. Among a prospective registry of 582 patients with metastatic MCC (mMCC), we identified 9 patients (1.5%) with cardiac involvement. We found that cardiac mMCC most commonly involves the right heart (8 of 9; 89%) and occurs relatively late in the disease process (median 925 days from the initial diagnosis to cardiac involvement). In our cohort, cardiac mMCC frequently responds to immunotherapy and cardiac radiotherapy, which can both be delivered with minimal cardiac toxicity. Cardiac involvement was not associated with worse survival compared to MCC patients with non-cardiac distant disease. These results are timely as cardiac mMCC may be increasingly encountered in the era of immunotherapy as patients with metastatic MCC live longer. Merkel cell carcinoma (MCC), an aggressive neuroendocrine skin cancer, has a high rate (20%) of distant metastasis. Within a prospective registry of 582 patients with metastatic MCC (mMCC) diagnosed between 2003–2021, we identified 9 (1.5%) patients who developed cardiac metastatic MCC (mMCC). We compared overall survival (OS) between patients with cardiac and non-cardiac metastases in a matched case–control study. Cardiac metastasis was a late event (median 925 days from initial MCC diagnosis). The right heart was predominantly involved (8 of 9; 89%). Among 7 patients treated with immunotherapy, 6 achieved a complete or partial response of the cardiac lesion. Among these 6 responders, 5 received concurrent cardiac radiotherapy (median 20 Gray) with immunotherapy; 4 of 5 did not have local disease progression or recurrence in the treated cardiac lesion. One-year OS was 44%, which was not significantly different from non-cardiac mMCC patients (45%, p = 0.96). Though it occurs relatively late in the disease course, cardiac mMCC responded to immunotherapy and/or radiotherapy and was not associated with worse prognosis compared to mMCC at other anatomic sites. These results are timely as cardiac mMCC may be increasingly encountered in the era of immunotherapy as patients with metastatic MCC live longer.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
DOI：
10.1111/bjd.19150
发表时间：
2021-03
期刊：
The British journal of dermatology
影响因子：
--
作者：
Akaike T;Qazi J;Anderson A;Behnia FS;Shinohara MM;Akaike G;Hippe DS;Thomas H;Takagishi SR;Lachance K;Park SY;Tarabadkar ES;Iyer JG;Blom A;Parvathaneni U;Vesselle H;Nghiem P;Bhatia S
通讯作者：
Bhatia S
影响因子：
168.9
作者：
Engels, EA;Frisch, M;Miller, RW
通讯作者：
Miller, RW
影响因子：
4.6
作者：
Akaike T;Nghiem P
通讯作者：
Nghiem P
复发性默克尔细胞癌的病例报告，与心脏和胃同步转移。
影响因子：
1.6
作者：
Ha JY;Park SE;Kim HS;Won H;Kim BJ;Hwang IG
通讯作者：
Hwang IG