TY - JOUR
T1 - Prognostic factors in Merkel cell carcinoma
T2 - Analysis of 240 cases
AU - Tarantola, Tina I.
AU - Vallow, Laura A.
AU - Halyard, Michele Y.
AU - Weenig, Roger H.
AU - Warschaw, Karen E.
AU - Grotz, Travis E.
AU - Jakub, James W.
AU - Roenigk, Randall K.
AU - Brewer, Jerry D.
AU - Weaver, Amy L.
AU - Otley, Clark C.
PY - 2013/3
Y1 - 2013/3
N2 - Background: Knowledge regarding behavior of and prognostic factors for Merkel cell carcinoma (MCC) is limited. Objective: We sought to further understand the characteristics, behavior, prognostic factors, and optimal treatment of MCC. Methods: A multicenter, retrospective, consecutive study of patients with known primary MCC was completed. Overall survival and survival free of locoregional recurrence were calculated and statistical analysis of characteristics and outcomes was performed. Results: Among the 240 patients, the mean age at diagnosis was 70.1 years, 168 (70.0%) were male, and the majority was Caucasian. The most common location was head and neck (111, 46.3%). Immunosuppressed patients had significantly worse survival, with an overall 3-year survival of 43.4% compared with 68.1% in immunocompetent patients. In our study, patients with stage II disease had improved overall survival versus those with stage I disease, in a statistically significant manner. Patients with stage III disease had significantly worse survival compared with stage I and with stage II. Primary tumor size did not predict nodal involvement. Conclusion: The data presented represent one of the largest series of primary MCC in the literature and confirm that MCC of all sizes has metastatic potential, supporting sentinel lymph node biopsy for all primary MCC. Because of the unpredictable natural history of MCC, we recommend individualization of care based on the details of each patient's tumor and clinical presentation.
AB - Background: Knowledge regarding behavior of and prognostic factors for Merkel cell carcinoma (MCC) is limited. Objective: We sought to further understand the characteristics, behavior, prognostic factors, and optimal treatment of MCC. Methods: A multicenter, retrospective, consecutive study of patients with known primary MCC was completed. Overall survival and survival free of locoregional recurrence were calculated and statistical analysis of characteristics and outcomes was performed. Results: Among the 240 patients, the mean age at diagnosis was 70.1 years, 168 (70.0%) were male, and the majority was Caucasian. The most common location was head and neck (111, 46.3%). Immunosuppressed patients had significantly worse survival, with an overall 3-year survival of 43.4% compared with 68.1% in immunocompetent patients. In our study, patients with stage II disease had improved overall survival versus those with stage I disease, in a statistically significant manner. Patients with stage III disease had significantly worse survival compared with stage I and with stage II. Primary tumor size did not predict nodal involvement. Conclusion: The data presented represent one of the largest series of primary MCC in the literature and confirm that MCC of all sizes has metastatic potential, supporting sentinel lymph node biopsy for all primary MCC. Because of the unpredictable natural history of MCC, we recommend individualization of care based on the details of each patient's tumor and clinical presentation.
KW - Merkel cell carcinoma
KW - neuroendocrine carcinoma
KW - nonmelanoma skin cancer
KW - primary neuroendocrine carcinoma of skin
KW - prognosis
KW - retrospective
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U2 - 10.1016/j.jaad.2012.09.036
DO - 10.1016/j.jaad.2012.09.036
M3 - Article
C2 - 23200197
AN - SCOPUS:84873716644
SN - 0190-9622
VL - 68
SP - 425
EP - 432
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 3
ER -