Seattle Multidisciplinary MCC TeamUniversity of Washington MCC ResearchFred Hutchinson Cancer Research Center Seattle Cancer Care Alliance/Skin Cancer

Prognosis
Disease recurrence and survival are two critical measures of prognosis (how a patient will do after a cancer diagnosis). Recurrence refers to whether the cancer ever comes back and “disease-specific survival”. The figures below show how MCC stage (http://merkelcell.org/staging/) affects the chance of recurrence or death from MCC.

“Kaplan-Meier” curves are a standard way to depict both recurrence-free survival and MCC-specific survival over time starting from diagnosis. In the Kaplan-Meier curves* shown below, each tick mark indicates a patient who was “censored” at that point and is no longer included in the data to the right of that point. Reasons for “censoring” include no follow up available beyond that date, or death from a non-MCC cause.

*link to the basics Kaplan-Meier curves: http://cancerguide.org/scurve_basic.html or more advanced description: http://cancerguide.org/scurve_km.html


Recurrence Risk after MCC
Recurrence-free survival is the chance that MCC has not recurred at a given time after diagnosis. Recurrence-free survival varies by stage, as shown below, but about 80% of all MCC recurrences occur in the first two years after diagnosis.
Recurrence free survival for 467 patients for all stages. These data are from the patients with stage IA (n=118), stage IB (n=60), stage IIA (n=32), stage IIB (n=22), stage IIIA (n=81), stage IIIB (n=125) and stage IV (n=29) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).

 



Recurrence free survival for 232 patients with stage I or II MCC. These data are from the patients with stage IA (n=118), stage IB (n=60), stage IIA (n=32) and stage IIB (n=22) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).

 

 


Recurrence free survival for 235 patients with stage III or IV MCC, breaking down stage IIIB known and unknown primary tumors. Some patients present without an identifiable primary MCC tumor (lesion) on the skin. These patients are referred to as having an “unknown primary tumor” and often present instead with an enlarged lymph node containing MCC. Unknown primary Stage IIIB patients tend to have less MCC recurrences relative to Stage IIIB patients with known primary tumors.

These data are from patients with stage IIIA (n=81), stage IIIB known primary tumors (n=58), stage IIIB unknown primary tumors (n=67) and stage IV (n=29) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).

 

 

MCC-Specific Survival
MCC-specific survival refers to the chance a patient will not have died of MCC at various times after initial MCC diagnosis. In general, patients with local or nodal disease have improved survival compared to patients with distant metastatic disease. Most deaths from MCC occur in the first three years after diagnosis.


MCC-specific survival for 234 patients with stage I or II MCC. These data are from the patients with stage IA (n= 118), stage IB (n= 61), stage IIA (n= 32) and stage IIB (n= 23) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).

 

 


MCC-specific survival for 238 patients with stage III or IV MCC. These data are from the patients with stage IIIA (n=81), stage IIIB (n=127) and stage IV (n=30) in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).

 

 


MCC-specific survival for 237 patients with stage IIIA, stage IIIB with known or unknown primary tumors and with stage IV. Some patients present without an identifiable primary MCC tumor (lesion) on the skin. These patients are referred to as having an “unknown primary tumor” and often present instead with an enlarged lymph node containing MCC. Known primary Stage IIIB patients have worsened outcomes relative to Stage IIIB patients with an unknown primary tumor, but not severe as stage IV patients. At three years, MCC specific survival for unknown primary tumor is about 80% versus 45% in known tumor patients, 80% stage IIIA, and 15% in stage IV.

These data are from patients with stage IIIA (n=81), stage IIIB known primary tumors (n=59) and stage IIIB unknown primary tumors (n=68) and stage IV (n= 29) enrolled in the Seattle based MCC cohort through December 2015. Staging was per AJCC 7th Edition system (http://merkelcell.org/staging/).