Study IDs predictors for Merkel cell carcinoma

Findings of a Kaiser Permanante study suggest that radiation treatment can help reduce the recurrence of Merkel cell carcinoma, but that chemotherapy appears to have little effect on recurrence or survival.

Seeking to characterize Merkel cell carcinoma (MCC) and identify recurrence and survival predictors, a research team led by Maryam M. Asgari, M.D., of Kaiser Permanente Northern California, conducted a cohort study involving 218 MCC patients who were followed from January 1995 through December 2009, according to a news release.

Using the Kaiser Permanente Northern California Cancer Registry, the researchers found that of those 218 patients, those who’d had radiation treatment had a 70 percent lower risk of disease recurrence while chemotherapy did not appear to have any impact on recurrence or survival. They also found that tumor extent - local, regional and distant - remained significantly associated with all outcomes, after adjusting for host, tumor, diagnostic and treatment variables.

Researchers noted a correlation between immunosuppression and higher MCC-specific mortality. Unknown primary site correlated with a reduced risk for distant metastasis and with improved survival. A lower risk of metastasis and improved survival were seen in association with pathological nodal evaluation.

“The most significant finding for dermatologists is in the area of Merkel cell carcinoma management,” Dr. Asgari tells Dermatology Times. “Pathologic nodal evaluation, such as a sentinel lymph node biopsy and lymphadenectomy, improve survival of Merkel cell carcinoma patients. Radiation treatment can reduce the likelihood of recurrence.

“However, chemotherapy did not improve odds of disease recurrence or survival,” she notes. “So the take-home point is for dermatologists to consider referring their Merkel cell carcinoma patients for surgical lymph node resection and radiation therapy.”

The findings were published online May 7 in JAMA Dermatology.

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