Effect of Patient, Tumor, and Treatment Variables on Outcome in a Cohort of Patients With Merkel Cell Carcinoma - Retrospective Study

Abstract

Introduction Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with high rates of recurrence and mortality. Known risk factors include ultraviolet radiation, immu-nosuppression, and Merkel cell polyomavirus (MCPyV). However, knowledge concerning pathophysiology and clinical behavior is lacking. Especially identifying prognostic factors to potentially improve MCC outcomes is of utmost importance. Material and Methods This retrospective study involved a cohort of 89 patients diagnosed with MCC between 1992 and 2016. Medical records were reviewed concerning host-, tumor-, diagnostic- and treatment variables. We used descriptive and inferential statistics to summarize characteristics and demonstrate associations with disease recurrence, overall survival and MCC-specific death. Results Among 89 patients with MCC, we observed several statistically significant associations. Sex (p = 0.009), tumor extent at time of diagnosis (p = 0.045) and initial treatment modality (p = 0.026) were associated with disease recurrence. Chemotherapy (p = 0.048) was further associated with a higher risk of recurrence. Initial treatment modality and pathologic nodal evaluation results (p = 0.045), were associated with overall survival. Age (p = 0.027), disease recurrence (p = 0.001), 1 to 6 months (p = 0.039) and 7 to 12 months (p = 0.003) to recurrence were associated with reduced overall survival. Musculoskeletal disease (p = 0.04) and radiotherapy (p = 0.005) were associated with improved overall survival. Tumor extent at time of diagnosis (p = 0.031) was further associated with MCC-specific death. Age (p = 0.031) and disease recurrence (p =

Date of Award	2020
Original language	English
Awarding Institution	Medical University Graz
Supervisor	Barbara Rainer (Supervisor) & Iris Zalaudek (Co-supervisor)