Browsing by Author "Their, Jenny"

Background: Merkel Cell Carcinoma (MCC) is a very rare but lethal skin cancer, most commonly presenting in elderly individuals with fair skin. UV-exposure or infection with the Merkel Cell Polyomavirus are crucial for the MCC pathogenesis. MCC most commonly presents as a local red-pink nodule, usually on UV-exposed skin areas of the head and neck or the extremities. The recommended treatment consists of a surgical tumour resection, a sentinel lymph node biopsy and adjuvant radiation therapy (RT), in metastatic MCC chemotherapy or immunotherapies can be added. Five-year survival is 40 - 70%. The aims for this study was to analyse MCC patients regarding patient and disease characteristics and administered treatments and the effects they pose on disease prognosis, with a special emphasis on radiation therapy. Methods: Data regarding patient and disease characteristics, treatments, disease progression and survival was collected from patient databases regarding all patients diagnosed with MCC at HUH in the period 2010-2018. Statistical analyses were made regarding independent variable effect on survival, with more thorough calulations regarding the effect on adjuvant radiotherapy. Results: 47 patients were included in this study. The mean age was 79 years, 59.6% were female, the primary tumour most commonly in the head and neck area and most patients presented with a local disease. 43 patients had a surgical re-excision, 28 patients received adjuvant RT, one patient was treated with chemotherapy and one with the immunotherapy avelumab. A small tumour size, low stage, lower patient age and treatment with adjuvant RT correlated with improved survival. Two-year survival was 57.1%. The disease specific survival for patients treated with RT was 74.0%, and 51.8% for patients who did not receive RT. Conclusion: The patient cohort was similar to those presented in previous studies. A small primary tumour, local disease, lower age at time of diagnosis and treatment with adjuvant RT was beneficial for survival. MCC is still an aggressive cancer with high mortality, and the administered treatments vary between patients at HUH.