P J Allen1, Z F Zhang, D G Coit. 1. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Abstract
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.
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.
Authors: J Crown; R Lipzstein; S Cohen; M Goldsmith; N Wisch; P A Paciucci; L Silverman; M Weiner; I Jaffrey; L Norton Journal: Cancer Invest Date: 1991 Impact factor: 2.176
Authors: Bianca D Lemos; Barry E Storer; Jayasri G Iyer; Jerri Linn Phillips; Christopher K Bichakjian; L Christine Fang; Timothy M Johnson; Nanette J Liegeois-Kwon; Clark C Otley; Kelly G Paulson; Merrick I Ross; Siegrid S Yu; Nathalie C Zeitouni; David R Byrd; Vernon K Sondak; Jeffrey E Gershenwald; Arthur J Sober; Paul Nghiem Journal: J Am Acad Dermatol Date: 2010-06-19 Impact factor: 11.527