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

Prognosis
Two critical measures of prognosis (how a patient will do after a cancer diagnosis) are whether the cancer ever comes back (recurrence free survival) and whether the patient dies of the cancer (cancer specific survival). The figures below show how MCC stage (http://merkelcell.org/staging/) affects the chance of recurrence or death from MCC.

“Kaplan-Meier” curves are a standard way to depict both recurrence-free survival and MCC-specific survival over time starting from diagnosis. In the Kaplan-Meier curves* shown below, each tick mark indicates a patient who was “censored” at that point and is no longer included in the data to the right of that point. Reasons for “censoring” include no follow up available beyond that date, or death from a non-MCC cause.

*link to the basics Kaplan-Meier curves: http://cancerguide.org/scurve_basic.html or more advanced description: http://cancerguide.org/scurve_km.html


Recurrence Free Survival
Recurrence-free survival is the chance that MCC has not recurred at a given time after diagnosis. Recurrence-free survival varies by stage, as shown below, but about 80% of all MCC recurrences occur in the first two years after diagnosis.

Recurrence free survival for 467 patients for all stages. These data are from the patients with stage IA (n= 118), stage IB (n= 60), stage IIA (n= 32), stage IIB (n= 22), stage IIIA (n= 81), stage IIIB (n= 125) and stage IV (n= 29) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).


Recurrence free survival for 232 patients with stage I or II MCC. These data are from the patients with stage IA (n= 118), stage IB (n= 60), stage IIA (n= 32) and stage IIB (n= 22) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).


Recurrence free survival for 235 patients with stage III or IV MCC, breaking down stage IIIB known and unknown primary tumors. Some patients present without an identifiable primary MCC tumor (lesion) on the skin. These patients are referred to as having an “unknown primary tumor” and often present instead with an enlarged lymph node containing MCC. Unknown primary Stage IIIB patients tend to have less MCC recurrences relative to Stage IIIB patients with known primary tumors.

These data are from patients with stage IIIA (n= 81), stage IIIB known primary tumors (n= 58), stage IIIB unknown primary tumors (n= 67) and stage IV (n= 29) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).

MCC-Specific Survival
MCC-specific survival refers to the chance a patient will not have died of MCC at various times after initial MCC diagnosis. In general, patients with local or nodal disease have improved survival compared to patients with distant metastatic disease. Most deaths from MCC occur in the first three years after diagnosis.


MCC-specific survival for 234 patients with stage I or II MCC. These data are from the patients with stage IA (n= 118), stage IB (n= 61), stage IIA (n= 32) and stage IIB (n= 23) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).


MCC-specific survival for 238 patients with stage III or IV MCC. These data are from the patients with stage IIIA (n= 81), stage IIIB (n= 127) and stage IV (n= 30) in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).


MCC-specific survival for 127 patients with stage IIIB or IV MCC with known or unknown primary tumors. Some patients present without an identifiable primary MCC tumor (lesion) on the skin. These patients are referred to as having an “unknown primary tumor” and often present instead with an enlarged lymph node containing MCC. Unknown primary Stage IIIB patients have marked improved outcomes relative to Stage IIIB patients with a known primary tumor. At three years, MCC specific survival for unknown primary tumor is about 75% versus 45% in known tumor patients.

These data are from patients with stage IIIB known primary tumors (n= 68), stage IIIB and stage IIIB unknown primary tumors (n= 59) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).