A better prognosis for Merkel cell carcinoma of unknown primary origin

Kathryn T. Chen, Pavlos Papavasiliou, Kyle Edwards, Fang Zhu, Clifford Perlis, Hong Wu, Aruna Turaka, Adam Berger, Jeffrey M. Farma

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

Background There is limited evidence that Merkel cell carcinoma (MCC) arising from a nodal basin without evidence of a primary cutaneous (PC) site has better prognosis. We present our experience at 2 tertiary care referral centers with stage III MCC with and without a PC site. Methods Fifty stage III MCC patients were identified between 1996 and 2011. Clinical data were analyzed, with primary endpoints being disease-free survival and overall survival. Results Of stage III patients, 34 patients presented with a PC site and 16 patients with an unknown primary (UP) site. Treatment strategies varied; of patients with UP vs PC sites, 25% vs 44% underwent combined regional lymphadenectomy and radiation, with an additional 25% vs 15% receiving chemotherapy. The median disease-free survival for a UP site was not reached vs 15 months for a PC site (hazards ratio =.48, P =.18). The median overall survival for a UP site was not reached vs 21 months for a PC site (hazards ratio =.34, P =.03). Multivariate analysis showed that UP status was a significant factor in overall survival (P =.002). Conclusions Stage III MCC with a UP site portends a better prognosis than MCC with a PC site.

Original languageEnglish (US)
Pages (from-to)752-757
Number of pages6
JournalAmerican Journal of Surgery
Volume206
Issue number5
DOIs
StatePublished - Nov 2013

All Science Journal Classification (ASJC) codes

  • Surgery

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