varadshinde
Search meeting site only annual meeting home program & abstracts registration housing past & future meetings   back to 2011 program d patients treated for merkel cell carcinoma at a single institution ryan c fields, md*, klaus busam, md*, joanne f chou, md*, katherine s panageas, md*, melissa p pulitzer, md*, dennis h kraus, md*, mary s brady, md*, daniel g coit, md memorial sloan-kettering cancer center, new york, ny objective: merkel cell carcinoma (mcc) is a rare cutaneous neoplasm. Staging and treatment are based on studies which incompletely characterize the disease. Here we present the largest series of patients with mcc and identify factors associated with survival. Methods: review of a prospective database was performed. Overall survival (os) was estimated by kaplan-meier and cox regression. Disease -specific survival (dss) was analyzed by competing risk methods. Results: 500 patients with mcc were prospectively identified. Median follow-up was 3 years. 51% of patients died during follow-up: 51% dod, 49% doc. 5-year os was 56% and cumulative incidence of death from mcc at 5 years was 30%. Stage and lymphovascular invasion (lvi) are predictive of survival (table). Notably, patients with clinically positive lymph nodes (3b) have decreased survival compared to microscopically positive (3a) or negative lymph nodes (1 and 2), while there is no difference in survival between stage 3a versus stage 1/2 (figure). Importantly, only one patient without lvi died of mcc during follow-up. Conclusions: os is a poor outcome measure in mcc. Presence of lvi and clinically, but not microscopically, positive lymph nodes are associated with decreased dss. Emphasis on these factors into mcc staging and treatment recommendations should be considered. Variables associated with overall and disease-specific survival variable overall survival disease-specific survival univariate hr (95% ci); p value multivariate hr (95% ci); p value univariate hr (95% ci); p value multivariate hr (95% ci); p value age (per 10 year increase) 1. 4 (1. 24-1. 62); <0. 01 1. 4 (1. 26-1. 65); <0. 01 0. generic viagra online viagra for sale cheap viagra buy cheap viagra cheap viagra online generic viagra online viagra for sale buy viagra viagra without a doctor prescription medicaresupplementspecialists.com/pfz-cheap-viagra-no-prescription-sy/ 98 (0. 82-1. 75); 0. 91 -- size of primary tumor (per 1cm increase) 1. 1 (1. 04-1. 16); <0. 01 ns 1. 12 (1. 10-1. 30); <0. 01 ns presence of lymphovascular invasion in primary tumor 2. 4 (1. 74-3. 45); <0. 01 1. 7 (1. 16-2. 58); <0. 01 na na positive margin 3. 3 (1. 86-5. 74); <0. 01 ns 3. 23 (1. 59-6. 54); <0. 01 ns stage: 4 v. 1 7. 8 (4. 51-13. 0); <0. 01 8. 0 (4. 4-14. 0); <0. 01 20. 1 (11-36); <0. 01 20. 1 (11-36); <0. 01 stage: 3b v. 1 2. 5 (1. 84-3. 60); <0. 01 2. 4 (1. 64-3. 74); <0. 01 6. 20 (3. 6-10. 4); <0. 01 6. 20 (3. 6-10. 4); <0. 01 stage: 3a v. 1 1. 2 (0. 71-2. 01); ns 0. 8 (0. 48-1. 50); ns 1. 70 (0. 70-4. 1); ns ns stage: 2 v. 1 1. 1 (0. 72-1. 73); ns 1. 1 (0. 69-1. 66); ns 1. 60 (0. 64-3. 7); ns ns back to 2011 program   © 2012 american surgical association. All rights reserved. P. Varad : The Blessings
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