Analysis of patients diagnosed and treated for Merkel cell carcinoma

Background: Merkel cell carcinoma is rare, aggressive, cutaneous malignancy with approximately 50% of cases arising in the head and neck. It occurs more frequently in older, light skinned individuals and tends to metastasise at an early stage. Merkel cell polyomavirus, ultra violet radiation exposure and immunosuppression have been associated with the pathogenesis of Merkel cell carcinoma. Merkel cell carcinoma arising in the head and neck has a worse prognosis compared to other sites. Management in the head and neck is challenging due to anatomic, functional and cosmetic limitations for surgeons owing to positive surgical margins and increased locoregional recurrence rates. Objective: The aim of this retrospective case series is to evaluate the outcomes of patients diagnosed and treated for Merkel cell carcinoma at the University of Florida, College of Medicine Jacksonville. Methods: Patients treated for Merkel cell carcinoma were identified through retrospective chart review from January 2009 to September 2016. Patient demographics, tumour site, comorbidities, presence of positive margins, and treatment modalities were correlated with outcomes. Survival rates were calculated using the Kaplan-Meier method. Findings and Conclusion: A total of seven patients were identified during this time period. Overall survival rate was 85.71%. The mean age was 76 years at time of initial treatment. 57% of patients experienced recurrent disease with a mean time to recurrence of 379.6 days. There was no significant association between disease-free survival time and age. While there was no correlation in this series with positive margins and those with recurrence, a larger prospective series may prove otherwise.