{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T08:53:21Z","timestamp":1791104001566,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>H&amp;N Merkel cell carcinoma (MCC) mainly affects elderly patients, yet age\u2010stratified treatment patterns and outcomes data are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 88 consecutive H&amp;N MCC patients (2000\u20132022) by age (&lt;\u200975 vs. \u2265\u200975\u2009years). OS was estimated by Kaplan\u2013Meier analysis and MCC\u2010specific death with competing\u2010risks methods (cause\u2010specific Cox regression).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 88 patients, 57% were \u2265\u200975\u2009years; older patients underwent less surgery but received RT at similar rates. Age\u2009\u2265\u200975 dominated OS (5\u2010year 23% vs. 71%; adjusted HR 3.24). The 5\u2010year cumulative incidence of MCC\u2010specific death was higher in older patients (42% vs. 23%) but was not independent after adjustment (cause\u2010specific HR 2.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.10); competing non\u2010MCC mortality was far higher (31% vs. 6%). Six of 11 ICI\u2010treated patients (55%) were alive at 1.9\u2009years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elderly patients undergo less surgery yet receive equivalent RT. Age dominates overall survival, but this mainly reflects competing non\u2010MCC mortality rather than a cancer\u2010specific effect; age\u2010tailored, competing\u2010risk\u2010aware protocols are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70496","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T05:47:41Z","timestamp":1791006461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment Patterns and Survival Outcomes of Head and Neck Merkel Cell Carcinoma: An Age\u2010Stratified Analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8379-1762","authenticated-orcid":false,"given":"Igor","family":"Vainer","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rabin Medical Center  Petah Tikva Israel"},{"name":"Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0301-3515","authenticated-orcid":false,"given":"Lior","family":"Strinkovsky","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rabin Medical Center  Petah Tikva Israel"},{"name":"Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1338-3189","authenticated-orcid":false,"given":"Eyal","family":"Fenig","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv Israel"},{"name":"Davidoff Cancer Center, Rabin Medical Center  Petah Tikva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6231-8975","authenticated-orcid":false,"given":"Gideon","family":"Bachar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rabin Medical Center  Petah Tikva Israel"},{"name":"Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13143506"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2025.05.001"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.10.028"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2022.07.015"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2023.03.004"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-pathmechdis-012419-032817"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/22925503211031934"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2021.06.009"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2025.1691000"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3401805"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2025.04.010"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820913622"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2022.03.043"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.02.056"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2025.115406"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603702"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-019-00427-9"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17193272"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/jitc-2022-004904"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2024.114261"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00769-9"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljac044"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms221910629"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28866"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-021-10031-z"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.11.031"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.27421"}],"container-title":["Head &amp; 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