Seattle Multidisciplinary MCC TeamUniversity of Washington MCC ResearchFred Hutchinson Cancer Research Center Seattle Cancer Care Alliance/Skin Cancer

There have been several studies evaluating survival in patients with MCC. Most of these studies have examined only a small number of patients due to the rarity of MCC. It is also difficult to compare these studies because each has examined patients with different characteristics such as age, location of MCC, stage of disease and prior treatments.

Nevertheless, some generalizations may be made based on these studies. Most deaths from MCC occur within the first 3 years of diagnosis.  Patients with stage I, II and III disease (e.g., local-regional disease) do better than patients with stage IV disease (e.g., metastatic disease).  Most exciting, a new study showed that patients who have no lymph node disease as detected by sentinel lymph node biopsy (SLNB) or other lymph node surgery have an excellent prognosis (Allen, 2005).

Fraction of patients with no recurrence among 237 MCC patients with stage I, II or III disease.  ~80 of all recurrences occur by 2 years after diagnosis. Adapted from Allen, 2005.

 

Relative survival for Merkel cell carcinoma by extent of disease at time of diagnosis. Percent relative survival was calculated for cases in the National Cancer Database using age- and sex-matched control data from the Centers for Disease Control and Prevention

 

Relative survival for 2,856 Merkel cell carcinoma patients by stage according to the 2009 AJCC staging system. Percent relative survival was calculated for cases in the National Cancer Database using age- and sex-matched control data from the Centers for Disease Control and Prevention. Stages are as indicated in the figure except for Stage IIIA which could not be derived using this dataset. The curve marked “IIIA*” represents pathologically node positive patients, with the clinical node status unknown or negative. It is anticipated that true Stage IIIA patients (clinical node status negative) have better survival than the line marked with “IIIA*.” Total number of patients was 2,856, and individual substages were as follows: IA = 266, IB = 754, IIA = 124, IIB = 414, IIC = 84, IIIA* = 794, IIIB = 143, IV = 277.  From AJCC Staging Manual 2009.   Click here for descriptions of stages.