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

Surgery

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

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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 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.

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	22 May 2018
DOIs	https://doi.org/10.1002/jso.25090
Publication status	Published - 15 Jun 2018

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10.1002/jso.25090

http://hdl.handle.net/1765/114124

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@article{7a9c48289aad4b2085f4795f174b8568,

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 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.",

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}",

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year = "2018",

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day = "15",

doi = "10.1002/jso.25090",

language = "English",

volume = "117",

pages = "1768--1775",

journal = "Journal of Surgical Oncology",

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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 - 2018/6/15

Y1 - 2018/6/15

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 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.

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 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.

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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