Clinical course of Merkel cell carcinoma: A DeCOG multicenter study of 1049 patients

Rákkutatás · Merkel cell carcinoma

Early radiation therapy within 8 weeks of diagnosis improves progression‑free probability and disease‑specific survival in Merkel cell carcinoma patients.

We performed a retrospective cohort study of 46 patients with head and neck Merkel cell carcinoma (MCC) treated by head and neck surgeons at Roswell Park Comprehensive Cancer Center between 2008 and 2022. Patients were identified using ICD-9 and ICD-10 codes. Clinical staging, pathologic findings, treatment modalities, recurrence rates, and survival outcomes were analyzed. Recurrence‑free survival and overall survival were evaluated using Kaplan‑Meier analysis. Among 46 patients, the cheek was the most common subsite (39.1 %). Cheek MCC was associated with significantly higher rates of parotid involvement and lymph‑node metastasis compared with other subsites (69.2 % vs. 25 %, Fisher p = 0.03). In multivariable analysis adjusting for age and immunosuppression, cheek location was an independent predictor of nodal positivity (adjusted odds ratio 7.4, 95 % CI 1.4–41.0, p = 0.02). Among patients who recurred, cheek primaries tended to recur earlier (median 4 vs. 12 months), though this trend was not statistically significant. No statistically significant difference was observed in 3‑year overall or recurrence‑free survival across subsites on Kaplan‑Meier analysis. Merkel cell carcinoma of the cheek is associated with increased parotid involvement and higher rates of nodal metastasis compared with other head and neck subsites, and cheek location was an independent predictor of nodal positivity. These findings suggest that anatomic subsite may influence disease behavior and highlight the need for larger studies to determine whether subsite‑specific management strategies are warranted.

The study identifies that administering adjuvant radiotherapy within eight weeks of diagnosis independently improves progression‑free probability and disease‑specific survival in Merkel cell carcinoma, providing evidence to guide optimal timing of local control strategies in this aggressive skin cancer.

Bizonyítékszint: Állatkísérletes. Állatmodellben vizsgálták.

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