{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:25:43Z","timestamp":1793607943308,"version":"4.5.0"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine carcinoma. Due to its relatively low incidence and limited prospective trials, current recommendations are guided by historical single-institution retrospective studies.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the overall survival (OS) of patients in Canada with head and neck MCC (HNMCC) according to American Joint Committee on Cancer 8th edition staging and treatment modalities.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n A retrospective cohort study of 400 patients with a diagnosis of HNMCC between July 1, 2000, and June 31, 2018, was conducted using the Pan-Canadian Merkel Cell Cancer Collaborative, a multicenter national registry of patients with MCC. Statistical analyses were performed from January to December 2022.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was 5-year OS. Multivariable analysis using a Cox proportional hazards regression model was performed to identify factors associated with survival.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Between 2000 and 2018, 400 patients (234 men [58.5%]; mean [SD] age at diagnosis, 78.4 [10.5] years) with malignant neoplasms found in the face, scalp, neck, ear, eyelid, or lip received a diagnosis of HNMCC. At diagnosis, 188 patients (47.0%) had stage I disease. The most common treatment overall was surgery followed by radiotherapy (161 [40.3%]), although radiotherapy alone was most common for stage IV disease (15 of 23 [52.2%]). Five-year OS was 49.8% (95% CI, 40.7%-58.2%), 39.8% (95% CI, 26.2%-53.1%), 36.2% (95% CI, 25.2%-47.4%), and 18.5% (95% CI, 3.9%-41.5%) for stage I, II, III, and IV disease, respectively, and was highest among patients treated with surgery and radiotherapy (49.9% [95% CI, 39.9%-59.1%]). On multivariable analysis, patients treated with surgery and radiotherapy had greater OS compared with those treated with surgery alone (hazard ratio [HR], 0.76 [95% CI, 0.46-1.25]); however, this was not statistically significant. In comparison, patients who received no treatment had significantly worse OS (HR, 1.93 [95% CI, 1.26-2.96)].<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of the largest Canada-wide evaluation of HNMCC survival outcomes, stage and treatment modality were associated with survival. Multimodal treatment was associated with greater OS across all disease stages.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.44127","type":"journal-article","created":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T11:34:27Z","timestamp":1700480067000},"page":"e2344127","source":"Crossref","is-referenced-by-count":13,"title":["Survival of Patients With Head and Neck Merkel Cell Cancer"],"prefix":"10.1001","volume":"6","author":[{"given":"Ameeta Lubina","family":"Nayak","sequence":"first","affiliation":[{"name":"Department of Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur Travis","family":"Pickett","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Delisle","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Dingley","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjeeta","family":"Mallick","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Hamilton","sequence":"additional","affiliation":[{"name":"BC Cancer, Department of Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Stuart","sequence":"additional","affiliation":[{"name":"BC Cancer, Department of Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Talbot","sequence":"additional","affiliation":[{"name":"BC Cancer, Department of Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"McKinnon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Foothills Hospital, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Jost","sequence":"additional","affiliation":[{"name":"Department of Surgery, Foothills Hospital, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Thiboutot","sequence":"additional","affiliation":[{"name":"Department of Surgery, Foothills Hospital, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Francescutti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hamilton Health Sciences Center, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sal","family":"Samman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hamilton Health Sciences Center, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Easson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Princess Margaret Hospital, Mount Sinai Hospital and University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Schellenberg","sequence":"additional","affiliation":[{"name":"Department of Surgery, Princess Margaret Hospital, Mount Sinai Hospital and University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaila","family":"Merchant","sequence":"additional","affiliation":[{"name":"Department of Surgery, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"La","sequence":"additional","affiliation":[{"name":"Department of Surgery, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Vanderbeck","sequence":"additional","affiliation":[{"name":"Department of Surgery, Queen\u2019s University, Kingston, Ontario, Canada"},{"name":"Now with Department of Pathology, Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Berger-Richardson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Hebbard","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Hershorn","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Younan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Centre Hospitalier de L\u2019Universit\u00e9 de Montreal, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Patocskai","sequence":"additional","affiliation":[{"name":"Department of Surgery, Centre Hospitalier de L\u2019Universit\u00e9 de Montreal, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Rodriguez-Qizilbash","sequence":"additional","affiliation":[{"name":"Department of Surgery, Centre Hospitalier de L\u2019Universit\u00e9 de Montreal, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Meguerditichian","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGill University Health Network, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanina","family":"Tchuente","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGill University Health Network, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Kazandjian","sequence":"additional","affiliation":[{"name":"Department of Surgery, McGill University Health Network, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Mathieson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial University, St-John\u2019s, Newfoundland, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farisa","family":"Hossain","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial University, St-John\u2019s, Newfoundland, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessika","family":"Hetu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universit\u00e9 de Sherbrooke, Sherbrooke, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Corsten","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelina","family":"Tohm\u00e9","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Nessim","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Johnson-Obaseki","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,11,20]]},"reference":[{"issue":"3","key":"zoi231286r1","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1111\/cup.v48.3","article-title":"Merkel cell carcinoma: a review.","volume":"48","author":"Walsh","year":"2021","journal-title":"J Cutan Pathol"},{"key":"zoi231286r2","doi-asserted-by":"publisher","first-page":"17077","DOI":"10.1038\/nrdp.2017.77","article-title":"Merkel cell 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