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. 2023 Jan 7;23(1):30.
doi: 10.1186/s12885-022-10349-1.

Merkel cell carcinoma: a forty-year experience at the Peter MacCallum Cancer Centre

Annie J Wang  1 , Brendan McCann  2 , William C L Soon  1 , Paolo B De Ieso  3 , Mathias Bressel  4 , Andrew Hui  5 , Margaret Chua  1 , David L Kok  6   7
Affiliations

Merkel cell carcinoma: a forty-year experience at the Peter MacCallum Cancer Centre

Annie J Wang et al. BMC Cancer. .

Abstract

Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine skin malignancy, with Australia having the highest reported incidence in the world. There is currently a lack of consensus regarding optimal management of this disease.

Methods: This was a retrospective audit conducted by reviewing existing medical records of MCC patients presenting to the Peter MacCallum Cancer Centre (PMCC) between 1980 and 2018. The primary endpoint was locoregional recurrence. The secondary endpoints were distant recurrence, disease-free survival (DFS) and overall survival (OS).

Results: A total of 533 patients were identified. Locoregional recurrence occurring at one, two and 5 years was 24, 31 and 32%, respectively. The estimated 5-year OS and DFS were 46% (95% Confidence Interval [CI] 41-51%) and 34% (95% CI 30-39%) respectively. Older age at diagnosis (hazard ratio [HR] per year = 1.07, 95% CI 1.06-1.07, p < 0.001), and larger primary tumour diameter (HR =1.16, 95% CI 1.03-1.31, p = 0.019) were associated with worse OS on multivariable analysis. Positive or negative histopathological margin status was not associated with OS or DFS differences in patients treated with post-operative radiotherapy.

Conclusions: In our study, about a third of patients developed locoregional recurrence, distal recurrence or both, and there appears to be no change over the last four decades. If treated with adjuvant radiotherapy, there is no difference in OS or DFS with positive surgical margins. Findings should influence future guidelines.

Keywords: Immunotherapy; Management; Merkel Cell Carcinoma; Radiotherapy; Surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Cumulative Incidence of Loco-regional Recurrence, Distant Recurrence and Death
Fig. 2
Fig. 2
Disease Free Survival and Overall Survival by initial treatment modality
Fig. 3
Fig. 3
Disease Free Survival and Overall Survival by stage
See this image and copyright information in PMC

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