Background: Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine carcinoma of the skin. Aim: To describe clinical outcome and prognostic factors of MCC patients in two expert-centers. Method: Patients with histologically confirmed MCC in 1990-2014 were included. Data on patient, tumor characteristics and treatment were retrospectively collected. Results: A total of 351 Patients were evaluated, 153 (44%) males, median age 74 years (range 28-94). Median follow-up time was 28 months (IQR 13-58). Median primary tumor size was 17 mm (range 2-135). At time of diagnosis 112 (32%) patients had lymph node metastases. The cohorts′ 5-year overall survival (OS) was 58%. Using a competing risk analysis the 5-year relapse and MCC related death was 42% and 22%. Adjuvant radiation therapy (XRT) was associated with reduced recurrence (SDH 0.54; CI 0.3-0.9). Nodal involvement (SDH 2.7; CI 1.1-6.6) and the male gender were associated with higher MCC related death (SDH 3.1; CI 1.2-7.9). Conclusion: In a large cohort a low MCC related death, in the presence of a low OS was seen. This indicates that a significant number of MCC patients die due to other causes than MCC. Adjuvant XRT was associated with relapse. Male gender and nodal metastasis were associated with MCC related death.

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Keywords Merkel cell carcinoma, neuroendocrine carcinoma, non-melanoma skin cancer, prognosis, survival
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Journal Journal of Surgical Oncology
van Veenendaal, L.M, van Akkooi, A.C.J, Verhoef, C, Grunhagen, D.J, Klop, W.M.C, Valk, G.D, & Tesselaar, M.E.T. (2018). Merkel cell carcinoma: Clinical outcome and prognostic factors in 351 patients. Journal of Surgical Oncology, 117(8), 1768–1775. doi:10.1002/jso.25090