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Five hundred patients with Merkel cell carcinoma evaluated at a single institution.

Publication ,  Conference
Fields, RC; Busam, KJ; Chou, JF; Panageas, KS; Pulitzer, MP; Allen, PJ; Kraus, DH; Brady, MS; Coit, DG
Published in: Ann Surg
September 2011

OBJECTIVE: To identify factors associated with survival in Merkel cell carcinoma (MCC). BACKGROUND: Merkel cell carcinoma is a rare cutaneous neoplasm. Staging and treatment are based on studies, which incompletely characterize the disease. METHODS: Review of a prospective database was performed. Overall survival (OS) was estimated by the Kaplan-Meier method. Disease-specific death (DSD) was analyzed by the competing risks method. Factors associated with OS and DSD were determined by the log-rank test and Gray's test, respectively. RESULTS: A total of 500 patients with MCC treated at our institution from 1969 to 2010 were identified. Eighty-eight patients presented older than 6 months after diagnosis and were excluded from further analysis. Of the remaining 412 patients, the median age at diagnosis was 71 years. Median follow-up was 3 years. Fifty percent of patients died during follow-up: 25% died of disease, 24% died of other causes. Five-year OS and DSD were 56% and 30%, respectively. Pathologic stage and lymphovascular invasion were independent predictors of DSD. Patients with metastatic disease (stage 4) or clinically positive lymph nodes (stage 3b) had increased DSD compared with patients with microscopically positive (stage 3a) or negative lymph nodes (stage 1 and 2). There was no difference in DSD between stage 3a or 2 compared with stage 1. Importantly, only 1 of 132 patients without lymphovascular invasion died of MCC. CONCLUSIONS: OS is a poor measure of the influence of MCC on life expectancy. The presence of lymphovascular invasion and clinically, but not microscopically, positive lymph nodes were associated with increased DSD. These factors should be incorporated into MCC staging and treatment recommendations.

Duke Scholars

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

September 2011

Volume

254

Issue

3

Start / End Page

465 / 473

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Skin Neoplasms
  • Research Design
  • Prospective Studies
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Irinotecan
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fields, R. C., Busam, K. J., Chou, J. F., Panageas, K. S., Pulitzer, M. P., Allen, P. J., … Coit, D. G. (2011). Five hundred patients with Merkel cell carcinoma evaluated at a single institution. In Ann Surg (Vol. 254, pp. 465–473). United States. https://doi.org/10.1097/SLA.0b013e31822c5fc1
Fields, Ryan C., Klaus J. Busam, Joanne F. Chou, Katherine S. Panageas, Melissa P. Pulitzer, Peter J. Allen, Dennis H. Kraus, Mary S. Brady, and Daniel G. Coit. “Five hundred patients with Merkel cell carcinoma evaluated at a single institution.” In Ann Surg, 254:465–73, 2011. https://doi.org/10.1097/SLA.0b013e31822c5fc1.
Fields RC, Busam KJ, Chou JF, Panageas KS, Pulitzer MP, Allen PJ, et al. Five hundred patients with Merkel cell carcinoma evaluated at a single institution. In: Ann Surg. 2011. p. 465–73.
Fields, Ryan C., et al. “Five hundred patients with Merkel cell carcinoma evaluated at a single institution.Ann Surg, vol. 254, no. 3, 2011, pp. 465–73. Pubmed, doi:10.1097/SLA.0b013e31822c5fc1.
Fields RC, Busam KJ, Chou JF, Panageas KS, Pulitzer MP, Allen PJ, Kraus DH, Brady MS, Coit DG. Five hundred patients with Merkel cell carcinoma evaluated at a single institution. Ann Surg. 2011. p. 465–473.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

September 2011

Volume

254

Issue

3

Start / End Page

465 / 473

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Skin Neoplasms
  • Research Design
  • Prospective Studies
  • Neoplasm Staging
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Irinotecan