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Chen KT , Papavasiliou P , Edwards K , Zhu F , Perlis C , Wu H , Turaka A , Berger A , Farma JM
A better prognosis for Merkel cell carcinoma of unknown primary origin
American Journal of Surgery. 2013 Nov;206(5) :752-757
PMID: WOS:000326510600023   
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BACKGROUND: There is limited evidence that Merkel cell carcinoma (MCC) arising from a nodal basin without evidence of a primary cutaneous (PC) site has better prognosis. We present our experience at 2 tertiary care referral centers with stage III MCC with and without a PC site. METHODS: Fifty stage III MCC patients were identified between 1996 and 2011. Clinical data were analyzed, with primary endpoints being disease-free survival and overall survival. RESULTS: Of stage III patients, 34 patients presented with a PC site and 16 patients with an unknown primary (UP) site. Treatment strategies varied; of patients with UP vs PC sites, 25% vs 44% underwent combined regional lymphadenectomy and radiation, with an additional 25% vs 15% receiving chemotherapy. The median disease-free survival for a UP site was not reached vs 15 months for a PC site (hazards ratio = .48, P = .18). The median overall survival for a UP site was not reached vs 21 months for a PC site (hazards ratio = .34, P = .03). Multivariate analysis showed that UP status was a significant factor in overall survival (P = .002). CONCLUSIONS: Stage III MCC with a UP site portends a better prognosis than MCC with a PC site. (C) 2013 Elsevier Inc. All rights reserved.
Chen, Kathryn T. Papavasiliou, Pavlos Edwards, Kyle Zhu, Fang Perlis, Clifford Wu, Hong Turaka, Aruna Berger, Adam Farma, Jeffrey M. Annual Meeting of the Society-of-Surgical-Oncology Mar, 2011 Orlando, FL Soc Surg Oncol