Merkel cell carcinoma: Clinical outcome and prognostic factors in 351 patients

Linde M. van Veenendaal; Alexander C.J. van Akkooi; Cees Verhoef; Dirk Jan Grünhagen; W. Martin C. Klop; Gerlof D. Valk; Margot E.T. Tesselaar

doi:10.1002/jso.25090

Merkel cell carcinoma: Clinical outcome and prognostic factors in 351 patients

Linde M. van Veenendaal^*, Alexander C.J. van Akkooi, Cees Verhoef, Dirk Jan Grünhagen, W. Martin C. Klop, Gerlof D. Valk, Margot E.T. Tesselaar

^*Corresponding author for this work

Department of Endocrine Oncology

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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 17mm (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.

Original language	English
Pages (from-to)	1768-1775
Number of pages	8
Journal	Journal of Surgical Oncology
Volume	117
Issue number	8
Early online date	2018
DOIs	https://doi.org/10.1002/jso.25090
Publication status	Published - Jun 2018

Keywords

Merkel cell carcinoma
Neuroendocrine carcinoma
Non-melanoma skin cancer
Prognosis
Survival
survival
neuroendocrine carcinoma
prognosis
non-melanoma skin cancer
Age Factors
Follow-Up Studies
Humans
Middle Aged
Male
Aged, 80 and over
Adult
Carcinoma, Merkel Cell/mortality
Female
Retrospective Studies
Chemotherapy, Adjuvant
Netherlands/epidemiology
Radiotherapy, Adjuvant
Neoplasm Recurrence, Local
Lymphatic Metastasis
Skin Neoplasms/mortality
Sex Factors
Aged
Cohort Studies

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10.1002/jso.25090

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@article{414a76b625a8495c97e24f740a33c97b,

title = "Merkel cell carcinoma: Clinical outcome and prognostic factors in 351 patients",

abstract = "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 17mm (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.",

keywords = "Merkel cell carcinoma, Neuroendocrine carcinoma, Non-melanoma skin cancer, Prognosis, Survival, survival, neuroendocrine carcinoma, prognosis, non-melanoma skin cancer, Age Factors, Follow-Up Studies, Humans, Middle Aged, Male, Aged, 80 and over, Adult, Carcinoma, Merkel Cell/mortality, Female, Retrospective Studies, Chemotherapy, Adjuvant, Netherlands/epidemiology, Radiotherapy, Adjuvant, Neoplasm Recurrence, Local, Lymphatic Metastasis, Skin Neoplasms/mortality, Sex Factors, Aged, Cohort Studies",

author = "{van Veenendaal}, {Linde M.} and {van Akkooi}, {Alexander C.J.} and Cees Verhoef and Gr{\"u}nhagen, {Dirk Jan} and Klop, {W. Martin C.} and Valk, {Gerlof D.} and Tesselaar, {Margot E.T.}",

note = "{\textcopyright} 2018 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.",

year = "2018",

month = jun,

doi = "10.1002/jso.25090",

language = "English",

volume = "117",

pages = "1768--1775",

journal = "Journal of Surgical Oncology",

issn = "0022-4790",

publisher = "Wiley-Liss Inc.",

number = "8",

}

TY - JOUR

T1 - Merkel cell carcinoma

T2 - Clinical outcome and prognostic factors in 351 patients

AU - van Veenendaal, Linde M.

AU - van Akkooi, Alexander C.J.

AU - Verhoef, Cees

AU - Grünhagen, Dirk Jan

AU - Klop, W. Martin C.

AU - Valk, Gerlof D.

AU - Tesselaar, Margot E.T.

PY - 2018/6

Y1 - 2018/6

N2 - 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 17mm (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.

AB - 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 17mm (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.

KW - Merkel cell carcinoma

KW - Neuroendocrine carcinoma

KW - Non-melanoma skin cancer

KW - Prognosis

KW - Survival

KW - survival

KW - neuroendocrine carcinoma

KW - prognosis

KW - non-melanoma skin cancer

KW - Age Factors

KW - Follow-Up Studies

KW - Humans

KW - Middle Aged

KW - Male

KW - Aged, 80 and over

KW - Adult

KW - Carcinoma, Merkel Cell/mortality

KW - Female

KW - Retrospective Studies

KW - Chemotherapy, Adjuvant

KW - Netherlands/epidemiology

KW - Radiotherapy, Adjuvant

KW - Neoplasm Recurrence, Local

KW - Lymphatic Metastasis

KW - Skin Neoplasms/mortality

KW - Sex Factors

KW - Aged

KW - Cohort Studies

UR - http://www.scopus.com/inward/record.url?scp=85047616027&partnerID=8YFLogxK

U2 - 10.1002/jso.25090

DO - 10.1002/jso.25090

M3 - Article

C2 - 29790179

SN - 0022-4790

VL - 117

SP - 1768

EP - 1775

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

IS - 8

ER -

Merkel cell carcinoma: Clinical outcome and prognostic factors in 351 patients

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Keywords

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