Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-19T22:38:58.671Z Has data issue: false hasContentIssue false

Merkel cell carcinoma of the head and neck: poorer prognosis than non-head and neck sites

Published online by Cambridge University Press:  15 February 2016

G B Morand
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Sir Mortimer B Davis Jewish General Hospital, McGill University, Montréal, Québec, Canada
J Madana
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Sir Mortimer B Davis Jewish General Hospital, McGill University, Montréal, Québec, Canada
S D Da Silva
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Sir Mortimer B Davis Jewish General Hospital, McGill University, Montréal, Québec, Canada
M P Hier
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Sir Mortimer B Davis Jewish General Hospital, McGill University, Montréal, Québec, Canada
A M Mlynarek
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Sir Mortimer B Davis Jewish General Hospital, McGill University, Montréal, Québec, Canada
M J Black*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Sir Mortimer B Davis Jewish General Hospital, McGill University, Montréal, Québec, Canada
*
Address for correspondence: Dr Martin J Black, Department of Otolaryngology – Head and Neck Surgery, Sir Mortimer B Davis Jewish General Hospital, 3755 Côte Ste-Catherine Road, Montréal, Québec, Canada H3 T 1E2 Fax: +1 514 843 1403 E-mail: [email protected]

Abstract

Background:

Merkel cell carcinoma is a rare, aggressive neurocutaneous malignancy. This study investigated whether patients with Merkel cell carcinoma in the head and neck had poorer outcomes than patients with Merkel cell carcinoma located elsewhere.

Methods:

A retrospective study was performed of patients with Merkel cell carcinoma treated at the Jewish General Hospital in Montréal, Canada, from 1993 to 2013. Associations between clinicopathological characteristics and disease-free and disease-specific survival rates were examined according to the Kaplan–Meier method.

Results:

Twenty-seven patients were identified. Although basic clinicopathological characteristics and treatments were similar between head and neck and non-head and neck Merkel cell carcinoma groups, disease-free and disease-specific survival rates were significantly lower in the head and neck Merkel cell carcinoma group (log-rank test; p = 0.043 and p = 0.001, respectively). Mortality was mainly due to distant metastasis.

Conclusion:

Patients with head and neck Merkel cell carcinoma had poorer survival rates than patients with non-head and neck Merkel cell carcinoma in our study. The tendency to obtain close margins, a less predictable metastatic pattern, and/or intrinsic tumour factors related to the head and neck may explain this discrepancy.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented orally at the SIFORL International Meeting of French ENT Societies, 12–15 June 2014, Montréal, Québec, Canada.

References

1Toker, C.Trabecular carcinoma of the skin. Arch Dermatol 1972;105:107–10CrossRefGoogle ScholarPubMed
2Albores-Saavedra, J, Batich, K, Chable-Montero, F, Sagy, N, Schwartz, AM, Henson, DE.Merkel cell carcinoma demographics, morphology, and survival based on 3870 cases: a population based study. J Cutan Pathol 2010;37:20–7Google Scholar
3Feng, H, Shuda, M, Chang, Y, Moore, PS.Clonal integration of a polyomavirus in human Merkel cell carcinoma. Science 2008;319:1096–100CrossRefGoogle ScholarPubMed
4Houben, R, Grimm, J, Willmes, C, Weinkam, R, Becker, JC, Schrama, D.Merkel cell carcinoma and Merkel cell polyomavirus: evidence for hit-and-run oncogenesis. J Invest Dermatol 2012;132:254–6Google Scholar
5Sastre-Garau, X, Peter, M, Avril, MF, Laude, H, Couturier, J, Rozenberg, F et al. Merkel cell carcinoma of the skin: pathological and molecular evidence for a causative role of MCV in oncogenesis. J Pathol 2009;218:4856CrossRefGoogle ScholarPubMed
6Shuda, M, Feng, H, Kwun, HJ, Rosen, ST, Gjoerup, O, Moore, PS et al. T antigen mutations are a human tumor-specific signature for Merkel cell polyomavirus. Proc Natl Acad Sci U S A 2008;105:16272–7CrossRefGoogle ScholarPubMed
7Becker, JC, Houben, R, Ugurel, S, Trefzer, U, Pfohler, C, Schrama, D.MC polyomavirus is frequently present in Merkel cell carcinoma of European patients. J Invest Dermatol 2009;129:248–50Google Scholar
8Bobos, M, Hytiroglou, P, Kostopoulos, I, Karkavelas, G, Papadimitriou, CS.Immunohistochemical distinction between Merkel cell carcinoma and small cell carcinoma of the lung. Am J Dermatopathol 2006;28:99104Google Scholar
9Lewis, KG, Weinstock, MA, Weaver, AL, Otley, CC.Adjuvant local irradiation for Merkel cell carcinoma. Arch Dermatol 2006;142:693700CrossRefGoogle ScholarPubMed
10Jouary, T, Leyral, C, Dreno, B, Doussau, A, Sassolas, B, Beylot-Barry, M et al. Adjuvant prophylactic regional radiotherapy versus observation in stage I Merkel cell carcinoma: a multicentric prospective randomized study. Ann Oncol 2012;23:1074–80Google Scholar
11Morand, G, Vital, D, Pezier, T, Holzmann, D, Roessle, M, Cozzio, A et al. Merkel cell carcinoma of the head and neck: a single institutional experience. J Skin Cancer 2013;2013:325086CrossRefGoogle ScholarPubMed
12Huber, GF.Modern management of Merkel cell carcinoma. Curr Opin Otolaryngol Head Neck Surg 2014;22:109–15Google Scholar
13Reichgelt, BA, Visser, O.Epidemiology and survival of Merkel cell carcinoma in the Netherlands. A population-based study of 808 cases in 1993–2007. Eur J Cancer 2011;47:579–85Google ScholarPubMed
14Smith, VA, Camp, ER, Lentsch, EJ.Merkel cell carcinoma: identification of prognostic factors unique to tumors located in the head and neck based on analysis of SEER data. Laryngoscope 2012;122:1283–90Google Scholar
15Kokoska, ER, Kokoska, MS, Collins, BT, Stapleton, DR, Wade, TP.Early aggressive treatment for Merkel cell carcinoma improves outcome. Am J Surg 1997;174:688–93Google Scholar
16Allen, PJ, Bowne, WB, Jaques, DP, Brennan, MF, Busam, K, Coit, DG.Merkel cell carcinoma: prognosis and treatment of patients from a single institution. J Clin Oncol 2005;23:2300–9Google Scholar
17Edge, S, Byrd, DR, Compton, CC, Fritz, AG, Greene, FL, Trotti, A, eds. AJCC Cancer Staging Manual, 7th edn.New York: Springer-Verlag, 2010Google Scholar
18Sullivan, SR, Scott, JR, Cole, JK, Chi, Y, Anaya, DA, Byrd, DR et al. Head and neck malignant melanoma: margin status and immediate reconstruction. Ann Plast Surg 2009;62:144–8CrossRefGoogle ScholarPubMed
19Kukko, H, Bohling, T, Koljonen, V, Tukiainen, E, Haglund, C, Pokhrel, A et al. Merkel cell carcinoma - a population-based epidemiological study in Finland with a clinical series of 181 cases. Eur J Cancer 2012;48:737–42Google Scholar
20Haerle, SK, Shiau, C, Goldstein, DP, Qiu, X, Erovic, BM, Ghazarian, D et al. Merkel cell carcinoma of the head and neck: potential histopathologic predictors. Laryngoscope 2013;123:3043–8Google Scholar
21Fields, RC, Busam, KJ, Chou, JF, Panageas, KS, Pulitzer, MP, Kraus, DH et al. Recurrence and survival in patients undergoing sentinel lymph node biopsy for Merkel cell carcinoma: analysis of 153 patients from a single institution. Ann Surg Oncol 2011;18:2529–37Google Scholar
22Fritsch, VA, Camp, ER, Lentsch, EJ.Sentinel lymph node status in Merkel cell carcinoma of the head and neck: not a predictor of survival. Head Neck 2014;36:571–9CrossRefGoogle Scholar
23de Rosa, N, Lyman, GH, Silbermins, D, Valsecchi, ME, Pruitt, SK, Tyler, DM et al. Sentinel node biopsy for head and neck melanoma: a systematic review. Otolaryngol Head Neck Surg 2011;145:375–82Google Scholar
24Mogha, A, Fautrel, A, Mouchet, N, Guo, N, Corre, S, Adamski, H et al. Merkel cell polyomavirus small T antigen mRNA level is increased following in vivo UV-radiation. PloS One 2010;5:e11423Google Scholar
25Waltari, M, Sihto, H, Kukko, H, Koljonen, V, Sankila, R, Bohling, T et al. Association of Merkel cell polyomavirus infection with tumor p53, KIT, stem cell factor, PDGFR-alpha and survival in Merkel cell carcinoma. Int J Cancer 2011;129:619–28Google Scholar
26Milner, J, Medcalf, EA.Cotranslation of activated mutant p53 with wild type drives the wild-type p53 protein into the mutant conformation. Cell 1991;65:765–74Google Scholar
27Van Gele, M, Kaghad, M, Leonard, JH, Van Roy, N, Naeyaert, JM, Geerts, ML et al. Mutation analysis of P73 and TP53 in Merkel cell carcinoma. Br J Cancer 2000;82:823–6Google Scholar