(HealthDay News) — For patients with Merkel cell carcinoma (MCC), predictors of recurrence and survival have been identified which may help to inform diagnostic and therapeutic management, according to a study published online May 7 in JAMA Dermatology.

Maryam M. Asgari, MD, MPH, from Kaiser Permanente Northern California in Oakland, and colleagues characterized MCC and analyzed predictors of disease recurrence and survival in a cohort study involving 218 patients with MCC. Patients were followed from Jan. 1, 1995, through Dec. 31, 2009.

The researchers found that tumor extent (local, regional, and distant) remained significantly associated with all outcomes, after adjustment for host, tumor, diagnostic, and treatment variables. 

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There was a correlation between immunosuppression and higher MCC-specific mortality (adjusted hazard ratio [aHR], 4.9). 

Unknown primary site correlated with a reduced risk for distant metastasis (aHR, 0.1) and with improved survival (aHR, 0.4). 

A lower risk of metastasis (aHR, 0.2) and improved survival were seen in association with pathological nodal evaluation. 

The risk of locoregional recurrence was reduced with radiation treatment (aHR, 0.3), while chemotherapy was not associated with any change in outcomes.

“Tumor site and extent, results of pathologic nodal evaluation, and the presence of radiation treatment were associated with MCC recurrence,” the researchers wrote. “Our findings may help to inform diagnostic and therapeutic management of MCCs.”

One author disclosed financial ties to the pharmaceutical industry.


  1. Asgari MM, Sokil MM, Warton EM, et al. Effect of Host, Tumor, Diagnostic, and Treatment Variables on Outcomes in a Large Cohort With Merkel Cell Carcinoma. JAMA Dermatol. 2014;doi:10.1001/jamadermatol.2013.8116.