Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; Scheie Eye Institute, Philadelphia, PA, USA.
Int J Oral Maxillofac Surg. 2022 Mar;51(3):314-322. doi: 10.1016/j.ijom.2021.05.014. Epub 2021 Jun 3.
While Merkel cell carcinoma (MCC) of the head and neck is highly malignant, it remains poorly characterized due to its rarity. The purpose of this study was to examine prognostic factors for overall survival (OS) and disease-specific survival (DSS) in patients with MCC of the head and neck region. The Surveillance, Epidemiology and End Results registry was reviewed for patients diagnosed between 1984 and 2016 with histologically confirmed, primary MCC of the head and neck region. A total of 2818 patients met the inclusion criteria, with a median age at diagnosis of 77 years. At five and 10 years, respectively, the OS was 42.4% and 25.1% and the DSS was 67.9% and 64.1%. Multivariate Cox analysis indicated that predictors of decreased DSS included age at diagnosis ≥75 years, white race, increasing tumor spread, lymph node involvement and either the lip or the scalp/neck as a primary site. When adjusting for the aforementioned factors, tumor depth was not found to be a prognostic factor for DSS. We anticipate these results will help clinicians to counsel patients regarding expectations and potential prognosis.
尽管头颈部 Merkel 细胞癌（MCC）恶性程度较高，但由于其罕见性，其特征仍描述不足。本研究旨在探讨头颈部 MCC 患者总生存（OS）和疾病特异性生存（DSS）的预后因素。本研究回顾了 1984 年至 2016 年间经组织学证实的头颈部原发性 MCC 患者的监测、流行病学和最终结果登记处的数据。共有 2818 例患者符合纳入标准，诊断时的中位年龄为 77 岁。分别在 5 年和 10 年时，OS 为 42.4%和 25.1%，DSS 为 67.9%和 64.1%。多变量 Cox 分析表明，DSS 降低的预测因素包括诊断时年龄≥75 岁、白种人、肿瘤扩散增加、淋巴结受累以及唇部或头皮/颈部作为原发部位。在调整上述因素后，肿瘤深度并未被发现是 DSS 的预后因素。我们预计这些结果将有助于临床医生为患者提供关于预期和潜在预后的咨询。
