Materiały źródłowe

• #1 Merkel cell carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6054450/

  Merkel cell carcinoma (MCC) is highly aggressive, and more than one-third of patients die of the disease; thus, MCC has a case-fatality rate higher than that currently observed with melanoma. […] The disease-specific survival was associated with the stage at diagnosis and localization. […] The presence of occult nodal metastasis is a strong prognostic factor; the reported 3-year overall survival was 88% for patients with negative SLNB versus 57.2% for patients with positive SLNB. […] Survival depends on the stage at diagnosis: 5-year survival is 62.8% in patients with stage I MCC, 34.8-54.6% in stage II, 26.8-40.3% in stage III and 13.5% in stage IV. […] Notably, patients with stage III MCC and an unknown primary tumour have a better prognosis than patients with stage III MCC and a known primary tumour. […] Spontaneous regression of even metastatic MCC has been reported, and is associated with improved prognosis.

• #2

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11145756/

  Merkel-cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin. It affects predominantly older, fair-skinned Caucasians and exhibits aggressive behaviour with a high recurrence rate and a propensity for early metastasis. Despite new advances in therapies for MCC, the prognosis remains poor. […] The 5-year overall survival (OS) in all MCC patients is between 48% and 63%: 64% in patients without metastases (stage I-II), 51% in those with regional LN involvement (stage III), 68% in those with an unknown primary tumour and 17%-29% in patients with distant metastases (stage IV). […] Retrospective data have shown that unfavourable clinical prognostic factors are the presence of regional and distant metastases, primary tumour diameter 2 cm and/or its extension beyond the dermis, location in the head/neck region, 75 years of age, male sex and presence of comorbidity, especially immunosuppression (e.g. HIV, chronic lymphocytic leukaemia).

• #3 The biology and treatment of Merkel cell carcinoma: current understanding and research priorities | Nature Reviews Clinical Oncology

  https://www.nature.com/articles/s41571-018-0103-2

  Merkel cell carcinoma (MCC) is frequently metastatic and has an estimated 33-46% disease-specific mortality. […] Larger primary tumour size correlates with an increased risk of metastatic disease, although MCCs of any size confer a substantial risk of occult metastasis, thus supporting the use of sentinel lymph node biopsy sampling for all patients with clinically node-negative disease. […] The presence of clinically detectable nodal disease is associated with worse outcomes than the presence of microscopic metastases. […] Studies of the prognostic role of MCPyV status have, thus far, had mixed results, predominantly finding either a worsened prognosis in patients with VN-MCC tumours or no difference relative to VP-MCC tumours. […] The largest study to date to incorporate both immunohistochemical and PCR-based evaluations of MCPyV status found a better prognosis in patients with VP-MCCs.

• #4 Clinicodemographic Prediction of Overall Survival in Patients with Head and Neck Merkel Cell Carcinoma: A Machine Learning Approach | medRxiv

  https://www.medrxiv.org/content/10.1101/2025.04.05.25325298.full

  Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy with a higher case-fatality rate than melanoma. The prognosis of MCC is complex and depends on many factors. Patients with MCC of head and neck region usually have poor prognosis with a five-year OS was 49.8% for stage I to 18.5% for stage IV. Head and Neck Merkel Cell Carcinoma (HNMCC) presents distinct clinical challenges due to its high risk of local relapse, even in early stages, particularly in facial regions. Also, survival outcomes can vary significantly, depending on several key factors including tumor stage, presence of molecular aberrations present, feasibility of surgical resection, and the presence of underlying diseases. Patients with HNMCC exhibit poorer survival compared to those with MCC in other regions, likely due to factors such as narrow surgical margins, unpredictable metastatic behavior, and tumor-specific characteristics; mortality is predominantly driven by distant metastases. This study found that machine learning and statistical models provide reliable survival predictions for head and neck Merkel cell carcinoma, with models like gradient boosting classifiers having acceptable outputs, especially for 2-year survival. The results from the Cox Proportional Hazards model indicated that female patients and those identified Asian/Pacific Islander experienced better survival outcomes in Merkel cell carcinoma. Conversely, older age, higher AJCC stage, the presence of distant metastasis, and having primary tumors located on the scalp and neck were significantly associated with poorer survival rates. The Cox Proportional Hazards (CPH) model was identified as having the best discrimination, with a C-index of 0.7, making it valuable in clinical prognostic settings. The RFS and Survival Tree models for MCC yielded lower C-index values of 0.591 and 0.582, respectively.

• #5 Survival Rates for Merkel Cell Carcinoma | American Cancer Society

  https://www.cancer.org/cancer/types/merkel-cell-skin-cancer/detection-diagnosis-staging/survival-rates.html

  Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any persons case. These statistics can be confusing and may lead you to have more questions. Ask your doctor how these numbers may apply to you. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of Merkel cell carcinoma (MCC) is 70%, it means that people who have that cancer are, on average, about 70% as likely as people who dont have that cancer to live for at least 5 years after being diagnosed.

• #6

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11145756/

  Merkel-cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin. It affects predominantly older, fair-skinned Caucasians and exhibits aggressive behaviour with a high recurrence rate and a propensity for early metastasis. Despite new advances in therapies for MCC, the prognosis remains poor. […] The 5-year overall survival (OS) in all MCC patients is between 48% and 63%: 64% in patients without metastases (stage I-II), 51% in those with regional LN involvement (stage III), 68% in those with an unknown primary tumour and 17%-29% in patients with distant metastases (stage IV). […] Retrospective data have shown that unfavourable clinical prognostic factors are the presence of regional and distant metastases, primary tumour diameter 2 cm and/or its extension beyond the dermis, location in the head/neck region, 75 years of age, male sex and presence of comorbidity, especially immunosuppression (e.g. HIV, chronic lymphocytic leukaemia).

• #7 Merkel Cell Carcinoma: Symptoms, Treatment and Prognosis

  https://www.cancercenter.com/cancer-types/skin-cancer/types/merkel-cell-carcinoma

  Merkel cell carcinoma is a rare but aggressive type of skin cancer. […] The rates of Merkel cell carcinoma are higher in white and male patients. Merkel cell carcinoma can spread easily to another region of the body and has high recurrence rates with one review finding that about 30 percent of patients whose cancers were caught in early or mid stages had a recurrence on the skin, according to the National Cancer Institute (NCI). […] The prognosis for Merkel cell carcinoma patients is influenced by many factors, such as: […] The NCI’s Surveillance, Epidemiology, and End Results (SEER) Program tracks cancer survival rates. […] According to the SEER database, the overall five-year relative survival rate for Merkel cell carcinoma is 64 percent. […] The detailed breakdown for five-year relative survival rates is based on the stage of the disease at the time of diagnosis. […] Its important to note that these numbers are estimates and that new treatments may have emerged, providing a better outlook. Other factors, such as the patients age and overall health, also may play a role. Early detection is a key factor in the prognosis of many cancers.

• #8 Merkel cell carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6054450/

  Merkel cell carcinoma (MCC) is highly aggressive, and more than one-third of patients die of the disease; thus, MCC has a case-fatality rate higher than that currently observed with melanoma. […] The disease-specific survival was associated with the stage at diagnosis and localization. […] The presence of occult nodal metastasis is a strong prognostic factor; the reported 3-year overall survival was 88% for patients with negative SLNB versus 57.2% for patients with positive SLNB. […] Survival depends on the stage at diagnosis: 5-year survival is 62.8% in patients with stage I MCC, 34.8-54.6% in stage II, 26.8-40.3% in stage III and 13.5% in stage IV. […] Notably, patients with stage III MCC and an unknown primary tumour have a better prognosis than patients with stage III MCC and a known primary tumour. […] Spontaneous regression of even metastatic MCC has been reported, and is associated with improved prognosis.

• #9

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11145756/

  Merkel-cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin. It affects predominantly older, fair-skinned Caucasians and exhibits aggressive behaviour with a high recurrence rate and a propensity for early metastasis. Despite new advances in therapies for MCC, the prognosis remains poor. […] The 5-year overall survival (OS) in all MCC patients is between 48% and 63%: 64% in patients without metastases (stage I-II), 51% in those with regional LN involvement (stage III), 68% in those with an unknown primary tumour and 17%-29% in patients with distant metastases (stage IV). […] Retrospective data have shown that unfavourable clinical prognostic factors are the presence of regional and distant metastases, primary tumour diameter 2 cm and/or its extension beyond the dermis, location in the head/neck region, 75 years of age, male sex and presence of comorbidity, especially immunosuppression (e.g. HIV, chronic lymphocytic leukaemia).

• #10 Merkel cell carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6054450/

  Merkel cell carcinoma (MCC) is highly aggressive, and more than one-third of patients die of the disease; thus, MCC has a case-fatality rate higher than that currently observed with melanoma. […] The disease-specific survival was associated with the stage at diagnosis and localization. […] The presence of occult nodal metastasis is a strong prognostic factor; the reported 3-year overall survival was 88% for patients with negative SLNB versus 57.2% for patients with positive SLNB. […] Survival depends on the stage at diagnosis: 5-year survival is 62.8% in patients with stage I MCC, 34.8-54.6% in stage II, 26.8-40.3% in stage III and 13.5% in stage IV. […] Notably, patients with stage III MCC and an unknown primary tumour have a better prognosis than patients with stage III MCC and a known primary tumour. […] Spontaneous regression of even metastatic MCC has been reported, and is associated with improved prognosis.

• #11

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11145756/

  Merkel-cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin. It affects predominantly older, fair-skinned Caucasians and exhibits aggressive behaviour with a high recurrence rate and a propensity for early metastasis. Despite new advances in therapies for MCC, the prognosis remains poor. […] The 5-year overall survival (OS) in all MCC patients is between 48% and 63%: 64% in patients without metastases (stage I-II), 51% in those with regional LN involvement (stage III), 68% in those with an unknown primary tumour and 17%-29% in patients with distant metastases (stage IV). […] Retrospective data have shown that unfavourable clinical prognostic factors are the presence of regional and distant metastases, primary tumour diameter 2 cm and/or its extension beyond the dermis, location in the head/neck region, 75 years of age, male sex and presence of comorbidity, especially immunosuppression (e.g. HIV, chronic lymphocytic leukaemia).

• #12 Clinicodemographic Prediction of Overall Survival in Patients with Head and Neck Merkel Cell Carcinoma: A Machine Learning Approach | medRxiv

  https://www.medrxiv.org/content/10.1101/2025.04.05.25325298.full

  Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy with a higher case-fatality rate than melanoma. The prognosis of MCC is complex and depends on many factors. Patients with MCC of head and neck region usually have poor prognosis with a five-year OS was 49.8% for stage I to 18.5% for stage IV. Head and Neck Merkel Cell Carcinoma (HNMCC) presents distinct clinical challenges due to its high risk of local relapse, even in early stages, particularly in facial regions. Also, survival outcomes can vary significantly, depending on several key factors including tumor stage, presence of molecular aberrations present, feasibility of surgical resection, and the presence of underlying diseases. Patients with HNMCC exhibit poorer survival compared to those with MCC in other regions, likely due to factors such as narrow surgical margins, unpredictable metastatic behavior, and tumor-specific characteristics; mortality is predominantly driven by distant metastases. This study found that machine learning and statistical models provide reliable survival predictions for head and neck Merkel cell carcinoma, with models like gradient boosting classifiers having acceptable outputs, especially for 2-year survival. The results from the Cox Proportional Hazards model indicated that female patients and those identified Asian/Pacific Islander experienced better survival outcomes in Merkel cell carcinoma. Conversely, older age, higher AJCC stage, the presence of distant metastasis, and having primary tumors located on the scalp and neck were significantly associated with poorer survival rates. The Cox Proportional Hazards (CPH) model was identified as having the best discrimination, with a C-index of 0.7, making it valuable in clinical prognostic settings. The RFS and Survival Tree models for MCC yielded lower C-index values of 0.591 and 0.582, respectively.

• #13 Clinicodemographic Prediction of Overall Survival in Patients with Head and Neck Merkel Cell Carcinoma: A Machine Learning Approach | medRxiv

  https://www.medrxiv.org/content/10.1101/2025.04.05.25325298v1.full-text

  Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy with a higher case-fatality rate than melanoma. The prognosis of MCC is complex and depends on many factors. Patients with MCC of head and neck region usually have poor prognosis with a five-year OS was 49.8% for stage I to 18.5% for stage IV. Head and Neck Merkel Cell Carcinoma (HNMCC) presents distinct clinical challenges due to its high risk of local relapse, even in early stages, particularly in facial regions. Also, survival outcomes can vary significantly, depending on several key factors including tumor stage, presence of molecular aberrations present, feasibility of surgical resection, and the presence of underlying diseases. Patients with HNMCC exhibit poorer survival compared to those with MCC in other regions, likely due to factors such as narrow surgical margins, unpredictable metastatic behavior, and tumor-specific characteristics; mortality is predominantly driven by distant metastases. This study found that machine learning and statistical models provide reliable survival predictions for head and neck Merkel cell carcinoma, with models like gradient boosting classifiers having acceptable outputs, especially for 2-year survival. The Cox Proportional Hazards (CPH) model was identified as having the best discrimination, with a C-index of 0.7, making it valuable in clinical prognostic settings. The RFS and Survival Tree models for MCC yielded lower C-index values of 0.591 and 0.582, respectively.

• #14 Skin Cancer – Merkel Cell Carcinoma Treatment & Management: Approach Considerations, Pharmacologic Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/870538-treatment

  Merkel cell carcinoma (MCC) is a deadly disease with a poor outlook for survival. Local recurrence occurs in 44% of patients; multiple local recurrences occur in 15%. These recurrences usually happen within 5 months after the primary lesion is treated. About 15% of patients have palpable nodes at the time of diagnosis. Lymph node metastases eventually develop in 55% of patients, and distant metastases develop in 34%. Most metastases occur before the eighth month after diagnosis. […] The presence of distant metastases is the only factor that is consistently predictive of the outcome. The mean time to death after the discovery of distant metastases is 5 months. Mortality rates for patients with distant metastases are 75-100%. In patients without distant metastases, mortality rates are 4%. […] The aforementioned study by Uitentuis et al found that in the Netherlands, out of a cohort of 1977 patients, the relative 5-year survival rate for individuals with Merkel cell carcinoma (MCC) was 63.0%, with greater mortality seen in males (hazard ratio [HR] 1.24), in patients of higher age (HR 1.07), in individuals with nodal invasion (HR 1.26), and in patients with distant disease spread (HR 2.44).

• #15

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11145756/

  Merkel-cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin. It affects predominantly older, fair-skinned Caucasians and exhibits aggressive behaviour with a high recurrence rate and a propensity for early metastasis. Despite new advances in therapies for MCC, the prognosis remains poor. […] The 5-year overall survival (OS) in all MCC patients is between 48% and 63%: 64% in patients without metastases (stage I-II), 51% in those with regional LN involvement (stage III), 68% in those with an unknown primary tumour and 17%-29% in patients with distant metastases (stage IV). […] Retrospective data have shown that unfavourable clinical prognostic factors are the presence of regional and distant metastases, primary tumour diameter 2 cm and/or its extension beyond the dermis, location in the head/neck region, 75 years of age, male sex and presence of comorbidity, especially immunosuppression (e.g. HIV, chronic lymphocytic leukaemia).

• #16 The biology and treatment of Merkel cell carcinoma: current understanding and research priorities | Nature Reviews Clinical Oncology

  https://www.nature.com/articles/s41571-018-0103-2

  Merkel cell carcinoma (MCC) is frequently metastatic and has an estimated 33-46% disease-specific mortality. […] Larger primary tumour size correlates with an increased risk of metastatic disease, although MCCs of any size confer a substantial risk of occult metastasis, thus supporting the use of sentinel lymph node biopsy sampling for all patients with clinically node-negative disease. […] The presence of clinically detectable nodal disease is associated with worse outcomes than the presence of microscopic metastases. […] Studies of the prognostic role of MCPyV status have, thus far, had mixed results, predominantly finding either a worsened prognosis in patients with VN-MCC tumours or no difference relative to VP-MCC tumours. […] The largest study to date to incorporate both immunohistochemical and PCR-based evaluations of MCPyV status found a better prognosis in patients with VP-MCCs.

• #17 Skin Cancer – Merkel Cell Carcinoma Treatment & Management: Approach Considerations, Pharmacologic Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/870538-treatment

  Merkel cell carcinoma (MCC) is a deadly disease with a poor outlook for survival. Local recurrence occurs in 44% of patients; multiple local recurrences occur in 15%. These recurrences usually happen within 5 months after the primary lesion is treated. About 15% of patients have palpable nodes at the time of diagnosis. Lymph node metastases eventually develop in 55% of patients, and distant metastases develop in 34%. Most metastases occur before the eighth month after diagnosis. […] The presence of distant metastases is the only factor that is consistently predictive of the outcome. The mean time to death after the discovery of distant metastases is 5 months. Mortality rates for patients with distant metastases are 75-100%. In patients without distant metastases, mortality rates are 4%. […] The aforementioned study by Uitentuis et al found that in the Netherlands, out of a cohort of 1977 patients, the relative 5-year survival rate for individuals with Merkel cell carcinoma (MCC) was 63.0%, with greater mortality seen in males (hazard ratio [HR] 1.24), in patients of higher age (HR 1.07), in individuals with nodal invasion (HR 1.26), and in patients with distant disease spread (HR 2.44).

• #18

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11145756/

  Merkel-cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin. It affects predominantly older, fair-skinned Caucasians and exhibits aggressive behaviour with a high recurrence rate and a propensity for early metastasis. Despite new advances in therapies for MCC, the prognosis remains poor. […] The 5-year overall survival (OS) in all MCC patients is between 48% and 63%: 64% in patients without metastases (stage I-II), 51% in those with regional LN involvement (stage III), 68% in those with an unknown primary tumour and 17%-29% in patients with distant metastases (stage IV). […] Retrospective data have shown that unfavourable clinical prognostic factors are the presence of regional and distant metastases, primary tumour diameter 2 cm and/or its extension beyond the dermis, location in the head/neck region, 75 years of age, male sex and presence of comorbidity, especially immunosuppression (e.g. HIV, chronic lymphocytic leukaemia).

• #19 The biology and treatment of Merkel cell carcinoma: current understanding and research priorities | Nature Reviews Clinical Oncology

  https://www.nature.com/articles/s41571-018-0103-2

  Nevertheless, both VP-MCCs and VN-MCCs can have clinically aggressive and fatal courses. […] Higher anti-VP1 antibody titres and the presence of anti-ST antibodies in the serum at diagnosis have been associated with more favourable outcomes. […] A finding of persistent or re-emergent anti-ST antibodies in sera has been associated with a poor prognosis and a high risk of disease recurrence. […] Interestingly, patients presenting with nodal or presumed metastatic MCC with no identifiable skin lesions can have better outcomes than patients with disease of the same stage with a known primary tumour. […] Analogously, data from multiple studies have confirmed the importance of immune competence as a determinant of prognosis in patients with MCC; immunosuppressed patients (including those with chronic lymphocytic leukaemia) have not only a higher incidence of MCC but also markedly worse survival outcomes.

• #20 Merkel cell carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6054450/

  Merkel cell carcinoma (MCC) is highly aggressive, and more than one-third of patients die of the disease; thus, MCC has a case-fatality rate higher than that currently observed with melanoma. […] The disease-specific survival was associated with the stage at diagnosis and localization. […] The presence of occult nodal metastasis is a strong prognostic factor; the reported 3-year overall survival was 88% for patients with negative SLNB versus 57.2% for patients with positive SLNB. […] Survival depends on the stage at diagnosis: 5-year survival is 62.8% in patients with stage I MCC, 34.8-54.6% in stage II, 26.8-40.3% in stage III and 13.5% in stage IV. […] Notably, patients with stage III MCC and an unknown primary tumour have a better prognosis than patients with stage III MCC and a known primary tumour. […] Spontaneous regression of even metastatic MCC has been reported, and is associated with improved prognosis.

• #21 The biology and treatment of Merkel cell carcinoma: current understanding and research priorities | Nature Reviews Clinical Oncology

  https://www.nature.com/articles/s41571-018-0103-2

  Merkel cell carcinoma (MCC) is frequently metastatic and has an estimated 33-46% disease-specific mortality. […] Larger primary tumour size correlates with an increased risk of metastatic disease, although MCCs of any size confer a substantial risk of occult metastasis, thus supporting the use of sentinel lymph node biopsy sampling for all patients with clinically node-negative disease. […] The presence of clinically detectable nodal disease is associated with worse outcomes than the presence of microscopic metastases. […] Studies of the prognostic role of MCPyV status have, thus far, had mixed results, predominantly finding either a worsened prognosis in patients with VN-MCC tumours or no difference relative to VP-MCC tumours. […] The largest study to date to incorporate both immunohistochemical and PCR-based evaluations of MCPyV status found a better prognosis in patients with VP-MCCs.

• #22 Merkel cell carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6054450/

  Merkel cell carcinoma (MCC) is highly aggressive, and more than one-third of patients die of the disease; thus, MCC has a case-fatality rate higher than that currently observed with melanoma. […] The disease-specific survival was associated with the stage at diagnosis and localization. […] The presence of occult nodal metastasis is a strong prognostic factor; the reported 3-year overall survival was 88% for patients with negative SLNB versus 57.2% for patients with positive SLNB. […] Survival depends on the stage at diagnosis: 5-year survival is 62.8% in patients with stage I MCC, 34.8-54.6% in stage II, 26.8-40.3% in stage III and 13.5% in stage IV. […] Notably, patients with stage III MCC and an unknown primary tumour have a better prognosis than patients with stage III MCC and a known primary tumour. […] Spontaneous regression of even metastatic MCC has been reported, and is associated with improved prognosis.

• #23 The biology and treatment of Merkel cell carcinoma: current understanding and research priorities | Nature Reviews Clinical Oncology

  https://www.nature.com/articles/s41571-018-0103-2

  Nevertheless, both VP-MCCs and VN-MCCs can have clinically aggressive and fatal courses. […] Higher anti-VP1 antibody titres and the presence of anti-ST antibodies in the serum at diagnosis have been associated with more favourable outcomes. […] A finding of persistent or re-emergent anti-ST antibodies in sera has been associated with a poor prognosis and a high risk of disease recurrence. […] Interestingly, patients presenting with nodal or presumed metastatic MCC with no identifiable skin lesions can have better outcomes than patients with disease of the same stage with a known primary tumour. […] Analogously, data from multiple studies have confirmed the importance of immune competence as a determinant of prognosis in patients with MCC; immunosuppressed patients (including those with chronic lymphocytic leukaemia) have not only a higher incidence of MCC but also markedly worse survival outcomes.

• #24

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11145756/

  The poor prognosis has also been linked to histopathological futures such as positive margins after resection, a high mitotic rate, infiltrative (rather than circumscribed) growth pattern, lymphovascular infiltration and p63 expression, whereas LT and RB1 protein expression and intratumoural CD8+ T-lymphocyte infiltration correlate with a more favourable prognosis. […] Programmed death-ligand 1 (PD-L1) expression is frequently detected in MCC tumour cells and the tumour microenvironment. Nevertheless, its expression does not correlate with prognosis. […] The role of MCPyV oncoprotein antibody testing is uncertain but it may be utilised in patients who are seropositive at baseline.

• #25

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11145756/

  The poor prognosis has also been linked to histopathological futures such as positive margins after resection, a high mitotic rate, infiltrative (rather than circumscribed) growth pattern, lymphovascular infiltration and p63 expression, whereas LT and RB1 protein expression and intratumoural CD8+ T-lymphocyte infiltration correlate with a more favourable prognosis. […] Programmed death-ligand 1 (PD-L1) expression is frequently detected in MCC tumour cells and the tumour microenvironment. Nevertheless, its expression does not correlate with prognosis. […] The role of MCPyV oncoprotein antibody testing is uncertain but it may be utilised in patients who are seropositive at baseline.

• #26 Histological pattern of Merkel cell carcinoma sentinel lymph node metastasis improves stratification of Stage III patients | Modern Pathology

  https://www.nature.com/articles/modpathol2015109

  Sentinel lymph node biopsy is used to stage Merkel cell carcinoma, but its prognostic value has been questioned. […] Predictors of outcome in sentinel lymph node positive Merkel cell carcinoma patients are poorly defined. […] At the time of follow-up, 30/63 (48%) patients had died with 21 (33%) attributable to Merkel cell carcinoma. […] Patients with pattern 1 metastases had poorer overall survival compared with patients with patterns 2-5 metastases (P=0.03), with 22/30 (73%) deaths occurring in pattern 1 patients. […] In multivariable analysis, the number of positive sentinel lymph nodes (1 or 2 versus >2, P<0.0001), age (70 versus <70, P=0.01), sentinel lymph node metastasis pattern (patterns 2-5 versus 1, P=0.02), and immune status (immunocompetent versus suppressed, P=0.03) were independent predictors of outcome, and could be used to stratify Stage III patients into three groups with markedly different outcomes.

• #27 Histological pattern of Merkel cell carcinoma sentinel lymph node metastasis improves stratification of Stage III patients | Modern Pathology

  https://www.nature.com/articles/modpathol2015109

  In Merkel cell carcinoma, the pattern of sentinel lymph node involvement provides important prognostic information and utilizing this data with other clinicopathological features facilitates risk stratification of Merkel cell carcinoma patients who may have management implications. […] The association of various clinicopathological factors with survival in Merkel cell carcinoma patients is summarized in Table 1. […] There was no indication that survival differed in patients with sentinel lymph node patterns 2 through 5 (P=0.28); however patients with pattern 1 tended to have worse overall survival than patients with these other patterns (P=0.03). […] Other factors associated with poorer overall survival were increased number of positive sentinel lymph nodes (P<0.0001) and older age at diagnosis (70, P=0.004).

• #28 The biology and treatment of Merkel cell carcinoma: current understanding and research priorities | Nature Reviews Clinical Oncology

  https://www.nature.com/articles/s41571-018-0103-2

  Merkel cell carcinoma (MCC) is frequently metastatic and has an estimated 33-46% disease-specific mortality. […] Larger primary tumour size correlates with an increased risk of metastatic disease, although MCCs of any size confer a substantial risk of occult metastasis, thus supporting the use of sentinel lymph node biopsy sampling for all patients with clinically node-negative disease. […] The presence of clinically detectable nodal disease is associated with worse outcomes than the presence of microscopic metastases. […] Studies of the prognostic role of MCPyV status have, thus far, had mixed results, predominantly finding either a worsened prognosis in patients with VN-MCC tumours or no difference relative to VP-MCC tumours. […] The largest study to date to incorporate both immunohistochemical and PCR-based evaluations of MCPyV status found a better prognosis in patients with VP-MCCs.

• #29 The biology and treatment of Merkel cell carcinoma: current understanding and research priorities | Nature Reviews Clinical Oncology

  https://www.nature.com/articles/s41571-018-0103-2

  Nevertheless, both VP-MCCs and VN-MCCs can have clinically aggressive and fatal courses. […] Higher anti-VP1 antibody titres and the presence of anti-ST antibodies in the serum at diagnosis have been associated with more favourable outcomes. […] A finding of persistent or re-emergent anti-ST antibodies in sera has been associated with a poor prognosis and a high risk of disease recurrence. […] Interestingly, patients presenting with nodal or presumed metastatic MCC with no identifiable skin lesions can have better outcomes than patients with disease of the same stage with a known primary tumour. […] Analogously, data from multiple studies have confirmed the importance of immune competence as a determinant of prognosis in patients with MCC; immunosuppressed patients (including those with chronic lymphocytic leukaemia) have not only a higher incidence of MCC but also markedly worse survival outcomes.

• #30 The biology and treatment of Merkel cell carcinoma: current understanding and research priorities | Nature Reviews Clinical Oncology

  https://www.nature.com/articles/s41571-018-0103-2

  Nevertheless, both VP-MCCs and VN-MCCs can have clinically aggressive and fatal courses. […] Higher anti-VP1 antibody titres and the presence of anti-ST antibodies in the serum at diagnosis have been associated with more favourable outcomes. […] A finding of persistent or re-emergent anti-ST antibodies in sera has been associated with a poor prognosis and a high risk of disease recurrence. […] Interestingly, patients presenting with nodal or presumed metastatic MCC with no identifiable skin lesions can have better outcomes than patients with disease of the same stage with a known primary tumour. […] Analogously, data from multiple studies have confirmed the importance of immune competence as a determinant of prognosis in patients with MCC; immunosuppressed patients (including those with chronic lymphocytic leukaemia) have not only a higher incidence of MCC but also markedly worse survival outcomes.

• #31

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11145756/

  The poor prognosis has also been linked to histopathological futures such as positive margins after resection, a high mitotic rate, infiltrative (rather than circumscribed) growth pattern, lymphovascular infiltration and p63 expression, whereas LT and RB1 protein expression and intratumoural CD8+ T-lymphocyte infiltration correlate with a more favourable prognosis. […] Programmed death-ligand 1 (PD-L1) expression is frequently detected in MCC tumour cells and the tumour microenvironment. Nevertheless, its expression does not correlate with prognosis. […] The role of MCPyV oncoprotein antibody testing is uncertain but it may be utilised in patients who are seropositive at baseline.

• #32 Clinicodemographic Prediction of Overall Survival in Patients with Head and Neck Merkel Cell Carcinoma: A Machine Learning Approach | medRxiv

  https://www.medrxiv.org/content/10.1101/2025.04.05.25325298.full

  Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy with a higher case-fatality rate than melanoma. The prognosis of MCC is complex and depends on many factors. Patients with MCC of head and neck region usually have poor prognosis with a five-year OS was 49.8% for stage I to 18.5% for stage IV. Head and Neck Merkel Cell Carcinoma (HNMCC) presents distinct clinical challenges due to its high risk of local relapse, even in early stages, particularly in facial regions. Also, survival outcomes can vary significantly, depending on several key factors including tumor stage, presence of molecular aberrations present, feasibility of surgical resection, and the presence of underlying diseases. Patients with HNMCC exhibit poorer survival compared to those with MCC in other regions, likely due to factors such as narrow surgical margins, unpredictable metastatic behavior, and tumor-specific characteristics; mortality is predominantly driven by distant metastases. This study found that machine learning and statistical models provide reliable survival predictions for head and neck Merkel cell carcinoma, with models like gradient boosting classifiers having acceptable outputs, especially for 2-year survival. The results from the Cox Proportional Hazards model indicated that female patients and those identified Asian/Pacific Islander experienced better survival outcomes in Merkel cell carcinoma. Conversely, older age, higher AJCC stage, the presence of distant metastasis, and having primary tumors located on the scalp and neck were significantly associated with poorer survival rates. The Cox Proportional Hazards (CPH) model was identified as having the best discrimination, with a C-index of 0.7, making it valuable in clinical prognostic settings. The RFS and Survival Tree models for MCC yielded lower C-index values of 0.591 and 0.582, respectively.

• #33 Clinicodemographic Prediction of Overall Survival in Patients with Head and Neck Merkel Cell Carcinoma: A Machine Learning Approach | medRxiv

  https://www.medrxiv.org/content/10.1101/2025.04.05.25325298v1.full-text

  Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy with a higher case-fatality rate than melanoma. The prognosis of MCC is complex and depends on many factors. Patients with MCC of head and neck region usually have poor prognosis with a five-year OS was 49.8% for stage I to 18.5% for stage IV. Head and Neck Merkel Cell Carcinoma (HNMCC) presents distinct clinical challenges due to its high risk of local relapse, even in early stages, particularly in facial regions. Also, survival outcomes can vary significantly, depending on several key factors including tumor stage, presence of molecular aberrations present, feasibility of surgical resection, and the presence of underlying diseases. Patients with HNMCC exhibit poorer survival compared to those with MCC in other regions, likely due to factors such as narrow surgical margins, unpredictable metastatic behavior, and tumor-specific characteristics; mortality is predominantly driven by distant metastases. This study found that machine learning and statistical models provide reliable survival predictions for head and neck Merkel cell carcinoma, with models like gradient boosting classifiers having acceptable outputs, especially for 2-year survival. The Cox Proportional Hazards (CPH) model was identified as having the best discrimination, with a C-index of 0.7, making it valuable in clinical prognostic settings. The RFS and Survival Tree models for MCC yielded lower C-index values of 0.591 and 0.582, respectively.

• #34 Clinicodemographic Prediction of Overall Survival in Patients with Head and Neck Merkel Cell Carcinoma: A Machine Learning Approach | medRxiv

  https://www.medrxiv.org/content/10.1101/2025.04.05.25325298.full

  Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy with a higher case-fatality rate than melanoma. The prognosis of MCC is complex and depends on many factors. Patients with MCC of head and neck region usually have poor prognosis with a five-year OS was 49.8% for stage I to 18.5% for stage IV. Head and Neck Merkel Cell Carcinoma (HNMCC) presents distinct clinical challenges due to its high risk of local relapse, even in early stages, particularly in facial regions. Also, survival outcomes can vary significantly, depending on several key factors including tumor stage, presence of molecular aberrations present, feasibility of surgical resection, and the presence of underlying diseases. Patients with HNMCC exhibit poorer survival compared to those with MCC in other regions, likely due to factors such as narrow surgical margins, unpredictable metastatic behavior, and tumor-specific characteristics; mortality is predominantly driven by distant metastases. This study found that machine learning and statistical models provide reliable survival predictions for head and neck Merkel cell carcinoma, with models like gradient boosting classifiers having acceptable outputs, especially for 2-year survival. The results from the Cox Proportional Hazards model indicated that female patients and those identified Asian/Pacific Islander experienced better survival outcomes in Merkel cell carcinoma. Conversely, older age, higher AJCC stage, the presence of distant metastasis, and having primary tumors located on the scalp and neck were significantly associated with poorer survival rates. The Cox Proportional Hazards (CPH) model was identified as having the best discrimination, with a C-index of 0.7, making it valuable in clinical prognostic settings. The RFS and Survival Tree models for MCC yielded lower C-index values of 0.591 and 0.582, respectively.

• #35 Clinicodemographic Prediction of Overall Survival in Patients with Head and Neck Merkel Cell Carcinoma: A Machine Learning Approach | medRxiv

  https://www.medrxiv.org/content/10.1101/2025.04.05.25325298v1.full-text

  Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy with a higher case-fatality rate than melanoma. The prognosis of MCC is complex and depends on many factors. Patients with MCC of head and neck region usually have poor prognosis with a five-year OS was 49.8% for stage I to 18.5% for stage IV. Head and Neck Merkel Cell Carcinoma (HNMCC) presents distinct clinical challenges due to its high risk of local relapse, even in early stages, particularly in facial regions. Also, survival outcomes can vary significantly, depending on several key factors including tumor stage, presence of molecular aberrations present, feasibility of surgical resection, and the presence of underlying diseases. Patients with HNMCC exhibit poorer survival compared to those with MCC in other regions, likely due to factors such as narrow surgical margins, unpredictable metastatic behavior, and tumor-specific characteristics; mortality is predominantly driven by distant metastases. This study found that machine learning and statistical models provide reliable survival predictions for head and neck Merkel cell carcinoma, with models like gradient boosting classifiers having acceptable outputs, especially for 2-year survival. The Cox Proportional Hazards (CPH) model was identified as having the best discrimination, with a C-index of 0.7, making it valuable in clinical prognostic settings. The RFS and Survival Tree models for MCC yielded lower C-index values of 0.591 and 0.582, respectively.

• #36 Histological pattern of Merkel cell carcinoma sentinel lymph node metastasis improves stratification of Stage III patients | Modern Pathology

  https://www.nature.com/articles/modpathol2015109

  Sentinel lymph node biopsy is used to stage Merkel cell carcinoma, but its prognostic value has been questioned. […] Predictors of outcome in sentinel lymph node positive Merkel cell carcinoma patients are poorly defined. […] At the time of follow-up, 30/63 (48%) patients had died with 21 (33%) attributable to Merkel cell carcinoma. […] Patients with pattern 1 metastases had poorer overall survival compared with patients with patterns 2-5 metastases (P=0.03), with 22/30 (73%) deaths occurring in pattern 1 patients. […] In multivariable analysis, the number of positive sentinel lymph nodes (1 or 2 versus >2, P<0.0001), age (70 versus <70, P=0.01), sentinel lymph node metastasis pattern (patterns 2-5 versus 1, P=0.02), and immune status (immunocompetent versus suppressed, P=0.03) were independent predictors of outcome, and could be used to stratify Stage III patients into three groups with markedly different outcomes.

• #37 Histological pattern of Merkel cell carcinoma sentinel lymph node metastasis improves stratification of Stage III patients | Modern Pathology

  https://www.nature.com/articles/modpathol2015109

  In Merkel cell carcinoma, the pattern of sentinel lymph node involvement provides important prognostic information and utilizing this data with other clinicopathological features facilitates risk stratification of Merkel cell carcinoma patients who may have management implications. […] The association of various clinicopathological factors with survival in Merkel cell carcinoma patients is summarized in Table 1. […] There was no indication that survival differed in patients with sentinel lymph node patterns 2 through 5 (P=0.28); however patients with pattern 1 tended to have worse overall survival than patients with these other patterns (P=0.03). […] Other factors associated with poorer overall survival were increased number of positive sentinel lymph nodes (P<0.0001) and older age at diagnosis (70, P=0.004).

• #38 Skin Cancer – Merkel Cell Carcinoma Treatment & Management: Approach Considerations, Pharmacologic Therapy, Surgical Therapy

  https://emedicine.medscape.com/article/870538-treatment

  Merkel cell carcinoma (MCC) is a deadly disease with a poor outlook for survival. Local recurrence occurs in 44% of patients; multiple local recurrences occur in 15%. These recurrences usually happen within 5 months after the primary lesion is treated. About 15% of patients have palpable nodes at the time of diagnosis. Lymph node metastases eventually develop in 55% of patients, and distant metastases develop in 34%. Most metastases occur before the eighth month after diagnosis. […] The presence of distant metastases is the only factor that is consistently predictive of the outcome. The mean time to death after the discovery of distant metastases is 5 months. Mortality rates for patients with distant metastases are 75-100%. In patients without distant metastases, mortality rates are 4%. […] The aforementioned study by Uitentuis et al found that in the Netherlands, out of a cohort of 1977 patients, the relative 5-year survival rate for individuals with Merkel cell carcinoma (MCC) was 63.0%, with greater mortality seen in males (hazard ratio [HR] 1.24), in patients of higher age (HR 1.07), in individuals with nodal invasion (HR 1.26), and in patients with distant disease spread (HR 2.44).

• #39 Three-year survival, correlates and salvage therapies in patients receiving first-line pembrolizumab for advanced Merkel cell carcinoma | Journal for ImmunoTherapy of Cancer

  https://jitc.bmj.com/content/9/4/e002478

  Merkel cell carcinoma (MCC) is an aggressive skin cancer associated with poor survival. […] The current study was undertaken to assess baseline and on-treatment factors associated with MCC regression and 3-year survival, and to explore the effects of salvage therapies in patients experiencing initial non-response or tumor progression after response or stable disease following first-line pembrolizumab therapy on Cancer Immunotherapy Trials Network-09/KEYNOTE-017. […] Overall response rate to pembrolizumab was 58% (complete response 30%+partial response 28%; 95%CI 43.2 to 71.8). […] Median progression-free survival (PFS) was 16.8 months (95%CI 4.6 to 43.4) and the 3-year PFS was 39.1%. […] Median OS was NR; the 3-year OS was 59.4% for all patients and 89.5% for responders. […] This study represents the longest available follow-up from any first-line anti-programmed death-(ligand) 1 (anti-PD-(L)1) therapy in MCC, confirming durable PFS and OS in a proportion of patients.

• #40 Three-year survival, correlates and salvage therapies in patients receiving first-line pembrolizumab for advanced Merkel cell carcinoma | Journal for ImmunoTherapy of Cancer

  https://jitc.bmj.com/content/9/4/e002478

  Merkel cell carcinoma (MCC) is an aggressive skin cancer associated with poor survival. […] The current study was undertaken to assess baseline and on-treatment factors associated with MCC regression and 3-year survival, and to explore the effects of salvage therapies in patients experiencing initial non-response or tumor progression after response or stable disease following first-line pembrolizumab therapy on Cancer Immunotherapy Trials Network-09/KEYNOTE-017. […] Overall response rate to pembrolizumab was 58% (complete response 30%+partial response 28%; 95%CI 43.2 to 71.8). […] Median progression-free survival (PFS) was 16.8 months (95%CI 4.6 to 43.4) and the 3-year PFS was 39.1%. […] Median OS was NR; the 3-year OS was 59.4% for all patients and 89.5% for responders. […] This study represents the longest available follow-up from any first-line anti-programmed death-(ligand) 1 (anti-PD-(L)1) therapy in MCC, confirming durable PFS and OS in a proportion of patients.

• #41 Three-year survival, correlates and salvage therapies in patients receiving first-line pembrolizumab for advanced Merkel cell carcinoma | Journal for ImmunoTherapy of Cancer

  https://jitc.bmj.com/content/9/4/e002478

  Improving the management of anti-PD-(L)1-refractory MCC remains a challenge and a high priority. […] The median OS for all patients in this study was not reached. Importantly, objective responders had a substantially improved OS (89.5%) compared with the total study population (59.4%) at 3 years, suggesting that objective response is an early predictor of long-term survival in patients with aMCC receiving first-line anti-PD-1 therapy. […] Here, we identify several baseline and on-treatment factors associated with survival assessed 30 months after initiating first-line pembrolizumab therapy for aMCC: ECOG PS 0, greater magnitude of reduction in tumor burden, and successful completion of 2 years of continuous therapy. […] Our study describes salvage treatments received by these patients. Several initial responders with subsequent relapse had sustained survival after retreatment with immune checkpoint blockade, similar to published experience in other cancers.

• #42 Three-year survival, correlates and salvage therapies in patients receiving first-line pembrolizumab for advanced Merkel cell carcinoma | Journal for ImmunoTherapy of Cancer

  https://jitc.bmj.com/content/9/4/e002478

  Improving the management of anti-PD-(L)1-refractory MCC remains a challenge and a high priority. […] The median OS for all patients in this study was not reached. Importantly, objective responders had a substantially improved OS (89.5%) compared with the total study population (59.4%) at 3 years, suggesting that objective response is an early predictor of long-term survival in patients with aMCC receiving first-line anti-PD-1 therapy. […] Here, we identify several baseline and on-treatment factors associated with survival assessed 30 months after initiating first-line pembrolizumab therapy for aMCC: ECOG PS 0, greater magnitude of reduction in tumor burden, and successful completion of 2 years of continuous therapy. […] Our study describes salvage treatments received by these patients. Several initial responders with subsequent relapse had sustained survival after retreatment with immune checkpoint blockade, similar to published experience in other cancers.

• #43 Merkel Cell Carcinoma (MCC) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/merkel-cell-carcinoma-mcc

  Although Merkel cell carcinoma is one of the most dangerous forms of skin cancer, the majority (75%) of people survive five years or more after diagnosis when the cancer has not spread. […] But those numbers worsen if the cancer spreads regionally or to distant locations in the body, underlining the importance of early detection and treatment. […] When Merkel cell carcinoma is discovered and treated early and hasn’t spread to other parts of the body, about 75% of people live for at least five years after diagnosis. The outcomes tend to be worse if the cancer spreads; thus, early detection and treatment are important.

• #44 Three-year survival, correlates and salvage therapies in patients receiving first-line pembrolizumab for advanced Merkel cell carcinoma | Journal for ImmunoTherapy of Cancer

  https://jitc.bmj.com/content/9/4/e002478

  Improving the management of anti-PD-(L)1-refractory MCC remains a challenge and a high priority. […] The median OS for all patients in this study was not reached. Importantly, objective responders had a substantially improved OS (89.5%) compared with the total study population (59.4%) at 3 years, suggesting that objective response is an early predictor of long-term survival in patients with aMCC receiving first-line anti-PD-1 therapy. […] Here, we identify several baseline and on-treatment factors associated with survival assessed 30 months after initiating first-line pembrolizumab therapy for aMCC: ECOG PS 0, greater magnitude of reduction in tumor burden, and successful completion of 2 years of continuous therapy. […] Our study describes salvage treatments received by these patients. Several initial responders with subsequent relapse had sustained survival after retreatment with immune checkpoint blockade, similar to published experience in other cancers.

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