Site Editor
Soo Park, MD
Soo Park, MD
Posted: Monday, March 28, 2022
The recurrence rate of Merkel cell carcinoma is higher than that of invasive melanoma, squamous cell carcinoma, and basal cell carcinoma. Paul Nghiem, MD, PhD, of the University of Washington and the Fred Hutchinson Cancer Research Center, Seattle, proposed that stage- and time-specific recurrence data may assist in appropriately focusing surveillance resources on patients and the key time intervals for recurrence. The findings from this prospective cohort study were published in JAMA Dermatology.
“Now we have data on the time intervals and cancer stages that merit higher or lower surveillance intensity,” stated coauthor Aubriana McEvoy, MD, also of the University of Washington, in an institutional press release. “The size of the data set has allowed us to see patterns more clearly, and we need data to drive optimal decision-making,” added Dr. Nghiem
The study included patients with Merkel cell carcinoma who were prospectively enrolled in a Seattle-based data repository between 2003 and 2019. Data on recurrence and survival were systematically collected each year through review of interval medical records and direct outreach to patients and health-care professionals. These data were analyzed between July 2019 and November 2021.
Of the 618 patients enrolled in the study, 223 experienced a recurrence of Merkel cell carcinoma. Of the total population, the median age of patients was 69, and 227 were female.
The 5-year recurrence rate of Merkel cell carcinoma was 40%. Risk of recurrence in the first year was high: 11% for patients with pathologic stage I disease and 58% for those with pathologic stage IV disease. Additionally, 95% of these recurrences occurred within the first 3 years. The Merkel cell carcinoma–specific survival rate was strongly stage-dependent (95% at 5 years with pathologic stage I vs. 41% with pathologic stage IV). This cohort experienced 187 patient deaths, with 121 (65%) due to Merkel cell carcinoma.
Disclosure: For full disclosures of study authors, visit jamanetwork.com.
JNCCN Spotlights
