Progression-, aggression-, survival and outcome characteristics in Merkel cell carcinomas in 176 patients.

Merkel cell carcinoma of the head and neck (HNMCC) is a rare but highly malignant tumour with an overall poor prognosis. The aim of this retrospective study was to identify risk predictors for tumour progression in 176 patients first diagnosed with HNMCC between 1986 and 2015. This study is one of the largest European retrospective cohort studies on HNMCC. Special attention should be paid to the identification with univariate analysis of risk factors for the development of local recurrence, loco-regional metastasis, distant metastasis and disease-specific survival. Numerous significant factors (for example: gender, age, ASA score (American Society of Anesthesiologists Score; (Patients constitution)), immunosuppression, TNM, R status, etc.) were identified that influence disease progression and disease-specific survival. It also appears that the influencing factors increase from local recurrence to loco-regional metastasis to distant metastasis. After 36 months of follow-up, mortality in HNMCC appears to have plateaued. In addition, the data presented here suggest that high-risk patients with clinical loco-regional metastasis (cN+) in particular benefit from neck dissection and that all other patients (cN0) should receive a diagnostic sentinel lymph node Biopsy, as recommended in the German guideline.