{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T18:36:37Z","timestamp":1776105397016,"version":"3.50.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Merkel cell carcinoma (MCC) is an aggressive neuroendocrine carcinoma of the skin. Our report describes the evolution of management and characteristics associated with recurrence, disease-specific survival (DSS) and overall survival (OS) in the treatment of MCC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A single institution retrospective review of MCC and SEER data to determine factors associated with RFS, DSS, and OS using a multivariable Cox regression on inverse-probability weighted cohorts.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One hundred fifty-nine patients were identified with a median age of 75. Of these, 96% were Caucasian and 60% male. Fifty-eight out of 159 (36%) of all patients were deceased with 21\/58 (36%) dead from MCC with a median follow-up of 3.1 years. Institutionally, trends over time demonstrated an increased use of immunotherapy with a concomitant decrease in chemotherapy and decreased use of radiotherapy alone. Institutionally and nationally, there has been increased surgical nodal staging. Institutionally, factors associated with shorter DSS included advanced age, active cigarette smoker (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002), cT2 disease (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.007), and MCC with unknown primary (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Institutionally, factors associated with shorter OS included ages \u2265\u00a075\u00a0years (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), an immunocompromised state (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), truncal primary site (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002), and cT2 disease (HR 9.59, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Changing practice patterns in MCC management have been driven by the adoption of immunotherapy. Our study highlights that competing risks of mortality in MCC patients likely prevents OS from being an accurate surrogate outcome measure to understand factors associated with DSS.\n<\/jats:p>\n              <\/jats:sec>","DOI":"10.1245\/s10434-021-10727-2","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T16:04:03Z","timestamp":1631030643000},"page":"415-424","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Merkel Cell Carcinoma: Changing Practice Patterns and Impact on Recurrence-Free and Overall Survival at a Single Institution and Nationally"],"prefix":"10.1245","volume":"29","author":[{"given":"Andrew","family":"Esposito","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Ariyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjela","family":"Galan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harriet","family":"Kluger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Clune","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thuy","family":"Tran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Olino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"issue":"1","key":"10727_CR1","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1001\/archderm.1972.01620040075020","volume":"105","author":"C Toker","year":"1972","unstructured":"Toker C. 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Dr. Weiss received consulting fees from Array Biopharma and MagellanRx. Drs. Kelly Olino, Sara Weiss, and Thuy Tran are supported by the National Cancer Institute of the National Institutes of Health under Award Number\u00a0K12CA215110. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Daniel Jacobs was supported by a grant from the William U. Gardner Memorial Student Research Fellowship at the Yale University School of Medicine. Received from the Yale University School of Medicine (author\u2019s affiliation).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}