Merkel cell carcinoma

Histologic features and prognosis

Authors

  • Aleodor A. Andea MD,

    Corresponding author
    1. Department of Pathology, Memorial Sloan- Kettering Cancer Center, New York, New York
    Current affiliation:
    1. Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
    • Department of Pathology, University of Alabama at Birmingham, 619 19th Street South, PD6A, Room 149, Birmingham, AL 35249===

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    • Fax: (205) 975-6922

  • Daniel G. Coit MD,

    1. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
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  • Bijal Amin MD,

    1. Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital, New York, New York
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  • Klaus J. Busam MD

    1. Department of Pathology, Memorial Sloan- Kettering Cancer Center, New York, New York
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Abstract

BACKGROUND.

Currently, little is known regarding the potential prognostic value of histologic features in primary cutaneous neuroendocrine (Merkel cell) carcinomas (MCC).

METHODS.

In a retrospective review of the tumor histology and clinical outcome data (median follow-up, 51 months; range, 3-224 months) of 156 patients with a diagnosis of MCC, the following histologic features were evaluated: tumor thickness, tumor size (greatest dimension of the tumor), microanatomic compartment involved by tumor (dermis and/or subcutis and/or deeper), tumor growth pattern (nodular circumscribed vs infiltrative), lymphovascular invasion (LVI), tumor-infiltrating lymphocytes, tumor necrosis, ulceration, and solar elastosis.

RESULTS.

The overall 5-year survival rate was 67.5%. On univariate analysis, parameters that were associated significantly with survival were tumor thickness (P = .001), tumor size (P = .0002), deepest anatomic compartment involved by tumor (P = .0003), tumor growth pattern (P = .003), LVI (P < .00001), tumor-infiltrating lymphocytes (P = .05), and solar elastosis (P = .04). On multivariate analysis, the presence of a nodular growth pattern, low tumor depth, and absence of LVI were associated with longer survival.

CONCLUSIONS.

In addition to the known prognostic value of tumor stage, 3 histologic features were identified to have prognostic significance: tumor thickness (depth of tumor invasion), the presence of LVI, and tumor growth pattern. Cancer 2008. © 2008 American Cancer Society.

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