title: Merkel cell carcinoma of the head and neck: potential histopathologic predictors.
abstract: OBJECTIVE
  To identify or confirm any new or suggested independent histopathological predictors in Merkel cell carcinoma (MCC) of the head and neck (HN) correlated with outcome.
  
  
  METHODS
  Retrospective chart and pathology review.
  
  
  METHODS
  Between 1990 and 2010, 58 patients with Merkel cell carcinoma of the head and neck HNMCC were identified for study. Pathologic specimens were reviewed and evaluated for independent prognostic factors and correlated with locoregional recurrence and disease-specific survival.
  
  
  RESULTS
  The 2- and 5-year disease-specific survival (DSS) rates were 72.7% and 63.6%, respectively. The local and regional recurrence rates were 12.0% and 24.1%, respectively. A total of 25.9% of the patients developed distant metastases during follow-up. Tumor size (< 1 cm vs. > 1 cm) and the presence of a positive deep resection margin were independently found to be significantly associated with regional recurrence (P = 0.01 and P = 0.04, respectively). No other prognostic factors could be identified.
  
  
  CONCLUSIONS
  Adjuvant radiotherapy cannot remediate a positive resection margin. Given these results, consideration for revision surgery should be considered for a positive deep margin. Frozen section analysis may help to define the margins in this invasive and aggressive disease.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada.
authors.forename: Stephan K
authors.initials: SK
authors.lastname: Haerle
authors.forename: Carolyn
authors.initials: C
authors.lastname: Shiau
authors.forename: David P
authors.initials: DP
authors.lastname: Goldstein
authors.forename: Xin
authors.initials: X
authors.lastname: Qiu
authors.forename: Boban M
authors.initials: BM
authors.lastname: Erovic
authors.forename: Danny
authors.initials: D
authors.lastname: Ghazarian
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Irish
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015266:Carcinoma, Merkel Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009864:Ontario / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: Merkel cell carcinoma; head and neck; histopathological predictors