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

There have been several studies evaluating survival in patients with MCC. Most of these studies have examined only a small number of patients due to the rarity of MCC. It is also difficult to compare these studies because each has examined patients with different characteristics such as age, location of MCC, stage of disease and prior treatments.

Nevertheless, some generalizations may be made based on these studies. Most deaths from MCC occur within the first 3 years of diagnosis.  Patients with stage I, II and III disease (e.g., local-regional disease) do better than patients with stage IV disease (e.g., metastatic disease).  Most exciting, a new study showed that patients who have no lymph node disease as detected by sentinel lymph node biopsy (SLNB) or other lymph node surgery have an excellent prognosis (Allen, 2005).

Fraction of patients with no recurrence among 237 MCC patients with stage I, II or III disease.  ~80 of all recurrences occur by 2 years after diagnosis. Adapted from Allen, 2005.


Relative survival for Merkel cell carcinoma by extent of disease at time of diagnosis. Percent relative survival was calculated for cases in the National Cancer Database using age- and sex-matched control data from the Centers for Disease Control and Prevention

MCC-specific survival for 219 stage I or II patients from the University of Washington, Seattle cohort. This includes patients that have been enrolled through June 2015.
In a Kaplan-Meier curve such as this, 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 further follow up available beyond that date or death from a non-MCC cause.

(Updated June 2015)

MCC-specific survival for 226 stage III or IV patients from the University of Washington, Seattle cohort. This Kaplan-Meier curve includes patients that have been enrolled through June 2015.
See the plot below for a breakdown of patients with stage IIIB disease based on whether they did or did not have a primary lesion in the skin.
(Updated June 2015)

MCC-specific survival by known primary verses unknown primary tumor status in Stage IIIB patients.
Some patients with nodal disease present with no known MCC tumor in the skin. These cases are referred to as having an “unknown primary tumor” and often present with an enlarged lymph node.┬áMultiple studies have shown that patients who present with MCC and no known primary tumor have significantly improved survival. In the Seattle cohort, patients with stage IIIB MCC and no primary tumor have a 71% reduced risk of dying from MCC, after controlling for age at diagnosis, sex, and treatment with radiation and chemotherapy, as compared to those with a known primary MCC. None of the patients with an unknown primary had significant immunosuppression. This strong association with the immune system suggests that patients with an unknown primary tumor have an enhanced MCC-specific immune response.