Pathologic nodal evaluation improves prognostic accuracy in Merkel cell carcinoma: Analysis of 5823 cases as the basis of the first consensus staging system

摘要: Background The management of Merkel cell carcinoma (MCC) has been complicated by a lack detailed prognostic data and the presence conflicting staging systems. Objective We sought to determine significance tumor size, clinical versus pathologic nodal evaluation, extent disease at presentation thereby derive first consensus staging/prognostic system for MCC. Methods A total 5823 prospectively enrolled MCC cases from National Cancer Data Base had follow-up (median 64 months) were used analyses. Results At 5 years, overall survival was 40% relative (compared with age- sex-matched population data) 54%. Among all cases, 66% presented local, 27% nodal, 7% distant metastatic disease. For presenting local only, smaller size associated better (stage I, ≤2 cm, years; stage II, >2 51%; P  Limitations does not capture disease-specific survival. Overall patients therefore calculate based on matched data. Conclusion Although majority (68%) in this nationwide cohort did undergo procedure may be indicated many as it improves accuracy important treatment implications those found have microscopic involvement.