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Prognostic Factors in Merkel Cell Carcinoma: A Retrospective Single-Center Study in 90 Patients

1
Surgical Oncology Unit, Veneto Institute of Oncology IOV–IRCCS, 35121 Padua, Italy
2
Dermatology Unit and Pathology Unit, Department of Medicine (DIMED), University of Padua, 35121 Padua, Italy
3
Independent Statistician, 35121 Solagna, Italy
4
Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35121 Padua, Italy
5
Radiotherapy Unit, Veneto Institute of Oncology, IOV–IRCCS, 35121 Padua, Italy
6
Department of Surgery, Oncology and Gastroenterology, University of Padua, 35121 Padua, Italy
7
Dermatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padua, Italy
*
Author to whom correspondence should be addressed.
These authors contributed equally to the work.
Cancers 2018, 10(10), 350; https://doi.org/10.3390/cancers10100350
Received: 6 August 2018 / Revised: 20 September 2018 / Accepted: 21 September 2018 / Published: 24 September 2018
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PDF [1905 KB, uploaded 24 September 2018]
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Abstract

Merkel Cell Carcinoma (MCC) is a rare but highly aggressive neuroendocrine neoplasm of the skin. This study aimed at describing characteristics, treatment, and prognosis of a series of consecutive cases of MCC patients, in order to contribute to the investigation of this rare malignancy and provide better patient care. This is a retrospective cohort study including all 90 patients diagnosed and/or treated for MCC between 1991 and 2018 at the Veneto Institute of Oncology in Padua (Italy). Patient and tumor characteristics, treatment, and immunohistochemical data were extracted from a prospectively collected local database. There were 68 primary (76%) and 22 non-primary (15 occult primary, three metastatic, four recurrence) tumors (24%). CK20 expression was associated with reduced overall (HR 2.92, 95% CI 1.04–8.16) and disease-specific (HR 4.62, 95% CI 1.31–16.28) survival. Immunomodulatory regimens for treatment of other comorbidities were associated with reduced disease-specific ((HR 2.15, 95% CI 1.06–4.36) and recurrence-free (HR 3.08, 95% CI 1.44–6.57) survival. Iatrogenic immunomodulation resulted as the main factor associated with impaired prognosis. Lack of CK20 expression was associated with better survival. View Full-Text
Keywords: Merkel cell carcinoma; neuroendocrine neoplasm; skin neoplasm; survival; CK20 expression; immunomodulatory drugs Merkel cell carcinoma; neuroendocrine neoplasm; skin neoplasm; survival; CK20 expression; immunomodulatory drugs
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Rastrelli, M.; Ferrazzi, B.; Cavallin, F.; Chiarion Sileni, V.; Pigozzo, J.; Fabozzi, A.; Tropea, S.; Vecchiato, A.; Costa, A.; Parisi, A.; Rossi, C.R.; Del Fiore, P.; Alaibac, M. Prognostic Factors in Merkel Cell Carcinoma: A Retrospective Single-Center Study in 90 Patients. Cancers 2018, 10, 350.

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