Merkel cell carcinoma recurrence risk estimation is improved by integrating factors beyond cancer stage: A multivariable model and web-based calculator.
J Am Acad Dermatol
; 90(3): 569-576, 2024 Mar.
Article
em En
| MEDLINE
| ID: mdl-37984720
ABSTRACT
BACKGROUND:
Merkel cell carcinoma (MCC) recurs in 40% of patients. In addition to stage, factors known to affect recurrence risk include sex, immunosuppression, unknown primary status, age, site of primary tumor, and time since diagnosis.PURPOSE:
Create a multivariable model and web-based calculator to predict MCC recurrence risk more accurately than stage alone.METHODS:
Data from 618 patients in a prospective cohort were used in a competing risk regression model to estimate recurrence risk using stage and other factors.RESULTS:
In this multivariable model, the most impactful recurrence risk factors were American Joint Committee on Cancer stage (P < .001), immunosuppression (hazard ratio 2.05; P < .001), male sex (1.59; P = .003) and unknown primary (0.65; P = .064). Compared to stage alone, the model improved prognostic accuracy (concordance index for 2-year risk, 0.66 vs 0.70; P < .001), and modified estimated recurrence risk by up to 4-fold (18% for low-risk stage IIIA vs 78% for high-risk IIIA over 5 years).LIMITATIONS:
Lack of an external data set for model validation. CONCLUSION/RELEVANCE As demonstrated by this multivariable model, accurate recurrence risk prediction requires integration of factors beyond stage. An online calculator based on this model (at merkelcell.org/recur) integrates time since diagnosis and provides new data for optimizing surveillance for MCC patients.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Cutâneas
/
Neoplasias Primárias Desconhecidas
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Carcinoma de Célula de Merkel
Limite:
Humans
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Male
Idioma:
En
Revista:
J Am Acad Dermatol
Ano de publicação:
2024
Tipo de documento:
Article