Higher rate of recurrence in Merkel cell carcinoma than other skin cancers

March 2022 Medical Research Nalinee Pathak

According to a study published recently in the journal JAMA Dermatology, the five-year recurrence rate in patients with Merkel cell carcinoma (MCC) is remarkably higher (40%) than the recurrence rate for melanoma and other skin cancers.

MCC is a rare and aggressive cancer of the skin that can be often fatal than invasive melanoma and basal-cell and squamous-cell carcinomas. The MCC is composed of cells that look very similar to ‘Merkel cells’ found in the outer layer of skin, i.e. epidermis.

The incidence of recurrences in MCC is still very unclear, and thus it is difficult to estimate the stage-specific risk of MCC recurrence. Mc-Evoy et al. have carried out a clinical analysis of 618 MCC patients (37% females; age range-11-98 years) to characterise the post-treatment risk of MCC diagnosis at various clinical stages of the disease.

Main findings

The researchers found that the risk of recurrence was high and related to the stage of the disease; 11% for stage I disease, 33% for stage IIA/IIB, 30% for stage IIIA, 45% for stage IIIB, and 58% for stage IV. Expectedly, the survival depended on the cancer stage at the time of diagnosis. For instance, the MCC-specific survival rate was considerably low (41%) in patients diagnosed at stage IV than those diagnosed at stage I (95%).

Conclusion

The analysis indicates a higher recurrence rate (40%) in MCC that is relatively higher than what is reported for invasive melanoma (19%), squamous cell carcinoma (5%-9%), or basal cell carcinoma (1%-2%) following definitive therapy. Also, as more than 90% of MCC recurrence occur within three years, the surveillance intensity should be adjusted accordingly. These findings will assist in focusing surveillance resources in patients when the recurrence risk is highest.

Reference

McEvoy AM, Lachance K, Hippe DS, et al. Recurrence and Mortality Risk of Merkel Cell Carcinoma by Cancer Stage and Time From Diagnosis. JAMA Dermatol. Published online February 23, 2022. doi:10.1001/jamadermatol.2021.6096

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