Merkel cell carcinoma: identification of prognostic factors unique to tumors located in the head and neck based on analysis of SEER data.

Merkel cell carcinoma (MCC) is an aggressive cutaneous neoplasm that occurs most frequently in the head and neck region. Because of its rarity, prognostic factors are poorly characterized. Head and neck MCC (HN-MCC) may require separate consideration from MCC that occurs in other anatomic regions. Our objective was to determine the relevance of clinicopathologic parameters as prognostic factors in a large series of patients with HN-MCC and to compare these to a series of patients with non-head and neck MCC (NHN-MCC). Retrospective analysis of large population database. Patients with MCC were identified using the Surveillance, Epidemiology, and End Results database and categorized according to tumor location either 1) within or 2) outside of the head and neck region. Clinicopathologic data were compared between groups. Retrospective univariable and multivariable analyses of factors associated with disease-specific survival (DSS) were performed. We identified 2,104 patients with HN-MCC and 2,272 with NHN-MCC. DSS was similar between groups. Independent prognostic factors in HN-MCC are male sex (P < .001), lip primary site (P = .005), tumor extension beyond the dermis (P = .03), histologically confirmed nodal disease (P < .001), absence of histologic lymph node evaluation (P = .01), and distant metastasis (P = .001). Male sex and tumor extension limited to the subcutis are prognostic factors that are unique to HN-MCC. Because independent markers of aggressive disease appear to be unique in HN-MCC, it is important that future studies provide separate consideration for HN-MCC to allow for the most accurate identification of prognostic indicators and assessment of treatment outcomes accordingly.

Smith VA ，Camp ER ，Lentsch EJ 《-》

Tumor location is an independent prognostic factor in head and neck Merkel cell carcinoma.

Smith VA ，MaDan OP ，Lentsch EJ 《-》

Population-based analysis of prognostic indicators in sebaceous carcinoma of the head and neck.

Due to the rarity of sebaceous carcinoma of the head and neck, few large series have been reported and prognostic factors remain largely undetermined. This study presents prognostic factors in survival in sebaceous carcinoma of the head and neck. Retrospective analysis was performed using the Surveillance Epidemiology and End Results (SEER) database for patients diagnosed with sebaceous carcinoma of the head and neck (SCHN). Clinicopathologic, treatment data, and 5-year disease specific survival were analyzed using univariable and multivariable regression analysis and Kaplan-Meier methodology. Of the 1,433 patients identified to have SCHN, 16 were node-positive (1.14%). On multivariable analysis, independent prognostic indicators were: age at diagnosis (HR = 1.03, P = .021), tumor grade (HR = 4.97, P = .038), and distant metastasis (HR = 7.52, P = .006). Nodal metastasis occurred exclusively with poorly or undifferentiated tumors and was not a significant prognostic factor on multivariable analysis. Elderly patients and patients with poorly differentiated tumors and/or distant disease at presentation have the highest risk of disease-specific mortality. Lymph node metastasis does not appear to be an independent prognostic factor in sebaceous cell carcinoma.

Thomas WW ，Fritsch VA ，Lentsch EJ 《-》

Sentinel lymph node status in Merkel cell carcinoma of the head and neck: not a predictor of survival.

The effect of sentinel lymph node status on survival in patients with Merkel cell carcinoma (MCC) of the head and neck is uncertain. We used the Surveillance Epidemiology and End Results (SEER) database to identify patients with MCC who underwent sentinel lymph node biopsy (SLNB). Clinicopathologic data and disease-specific survival (DSS) were compared among patients with positive and negative sentinel lymph nodes. We identified 721 patients with cutaneous MCC who underwent SLNB, of which 173 (24%) had head and neck MCC. The rate of sentinel lymph node positivity in patients with head and neck MCC was 23.1%. Sentinel lymph node metastasis did not significantly affect survival in head and neck MCC (p = .139). Using the SEER database, we report what we believe to be the largest head and neck MCC study to date. Our results suggest that sentinel lymph node status does not predict survival in head and neck MCC. Independent predictors of MCC-related mortality seem to be unique in the head and neck region.

Fritsch VA ，Camp ER ，Lentsch EJ 《-》

Merkel cell carcinoma: does tumor size or depth of invasion correlate with recurrence, metastasis, or patient survival?

Sandel HD 4th ，Day T ，Richardson MS ，Scarlett M ，Gutman KA ... -  《LARYNGOSCOPE》