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Merkel cell carcinoma: Identification of prognostic factors unique to tumors located in the head and neck based on analysis of SEER data

Authors

  • Valerie A. Smith BA,

    1. College of Medicine, Medical University of South Carolina, Charleston, South Carolina, U.S.A
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  • E. Ramsay Camp MD,

    1. Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, U.S.A
    2. Department of Surgery–Division of Surgical Oncology, Medical University of South Carolina, Charleston, South Carolina, U.S.A
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  • Eric J. Lentsch MD

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
    • 135 Rutledge Avenue MSC 550, Charleston, SC 29425-5500
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  • This abstract has been accepted for a poster presentation at the Multidisciplinary Head and Neck Cancer Symposium, Phoenix, Arizona, U.S.A., January 26–28, 2012.

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

Merkel cell carcinoma (MCC) is an aggressive cutaneous neoplasm that occurs most frequently in the head and neck region. Because of its rarity, prognostic factors are poorly characterized. Head and neck MCC (HN-MCC) may require separate consideration from MCC that occurs in other anatomic regions. Our objective was to determine the relevance of clinicopathologic parameters as prognostic factors in a large series of patients with HN-MCC and to compare these to a series of patients with non–head and neck MCC (NHN-MCC).

Study Design:

Retrospective analysis of large population database.

Methods:

Patients with MCC were identified using the Surveillance, Epidemiology, and End Results database and categorized according to tumor location either 1) within or 2) outside of the head and neck region. Clinicopathologic data were compared between groups. Retrospective univariable and multivariable analyses of factors associated with disease-specific survival (DSS) were performed.

Results:

We identified 2,104 patients with HN-MCC and 2,272 with NHN-MCC. DSS was similar between groups. Independent prognostic factors in HN-MCC are male sex (P < .001), lip primary site (P = .005), tumor extension beyond the dermis (P = .03), histologically confirmed nodal disease (P < .001), absence of histologic lymph node evaluation (P = .01), and distant metastasis (P = .001). Male sex and tumor extension limited to the subcutis are prognostic factors that are unique to HN-MCC.

Conclusions:

Because independent markers of aggressive disease appear to be unique in HN-MCC, it is important that future studies provide separate consideration for HN-MCC to allow for the most accurate identification of prognostic indicators and assessment of treatment outcomes accordingly.

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