Surgical management of Merkel cell carcinoma.

Journal Article (Journal Article)

OBJECTIVES: To characterize the natural history of Merkel cell carcinoma (MCC) and to analyze the influence of patient, tumor, and treatment-related variables on survival and recurrence. SUMMARY BACKGROUND DATA: Approximately 425 cases of MCC have been described in the literature. This study represents the largest experience reported. METHODS: A review was performed of patients who had been treated at Memorial Sloan-Kettering Cancer Center for MCC between 1969 and 1996. Follow-up data were available for 102 of the 109 (94%) patients identified. RESULTS: The overall 5-year disease-specific survival rate was 74%. The median follow-up was 35 months. For all patients, the only independent predictor of survival was the tumor stage at presentation. For patients with stage I disease, the tumor size at presentation was also an independent predictor of survival. Recurrence of disease occurred in 55 patients (55%), and the most common site of first recurrence was within the draining lymph nodes (n = 35). Elective lymph node dissection was the only parameter independently predictive of improved relapse-free survival. The overall disease-specific survival rate after recurrence was 62%. Predictors of improved disease-specific survival after recurrence included nodal as compared to local or distant recurrence, the ability to render the patient free of disease after recurrence, and a disease-free interval of >8 months. CONCLUSION: The prognosis for patients with MCC is favorable, and even after recurrence the majority of patients experience long-term survival. Incorporation of size into the staging system more accurately predicts survival in patients with stage I disease. Although elective lymph node dissection decreased the rate of recurrence, it was not associated with improved overall survival.

Full Text

Duke Authors

Cited Authors

  • Allen, PJ; Zhang, ZF; Coit, DG

Published Date

  • January 1999

Published In

Volume / Issue

  • 229 / 1

Start / End Page

  • 97 - 105

PubMed ID

  • 9923806

Pubmed Central ID

  • PMC1191614

International Standard Serial Number (ISSN)

  • 0003-4932

Digital Object Identifier (DOI)

  • 10.1097/00000658-199901000-00013


  • eng

Conference Location

  • United States