title: Merkel cell carcinoma of the head and neck: poorer prognosis than non-head and neck sites.
abstract: BACKGROUND
  Merkel cell carcinoma is a rare, aggressive neurocutaneous malignancy. This study investigated whether patients with Merkel cell carcinoma in the head and neck had poorer outcomes than patients with Merkel cell carcinoma located elsewhere.
  
  
  METHODS
  A retrospective study was performed of patients with Merkel cell carcinoma treated at the Jewish General Hospital in Montréal, Canada, from 1993 to 2013. Associations between clinicopathological characteristics and disease-free and disease-specific survival rates were examined according to the Kaplan-Meier method.
  
  
  RESULTS
  Twenty-seven patients were identified. Although basic clinicopathological characteristics and treatments were similar between head and neck and non-head and neck Merkel cell carcinoma groups, disease-free and disease-specific survival rates were significantly lower in the head and neck Merkel cell carcinoma group (log-rank test; p = 0.043 and p = 0.001, respectively). Mortality was mainly due to distant metastasis.
  
  
  CONCLUSIONS
  Patients with head and neck Merkel cell carcinoma had poorer survival rates than patients with non-head and neck Merkel cell carcinoma in our study. The tendency to obtain close margins, a less predictable metastatic pattern, and/or intrinsic tumour factors related to the head and neck may explain this discrepancy.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Sir Mortimer B Davis Jewish General Hospital,McGill University,Montréal,Québec,Canada.
authors.forename: G B
authors.initials: GB
authors.lastname: Morand
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Sir Mortimer B Davis Jewish General Hospital,McGill University,Montréal,Québec,Canada.
authors.forename: J
authors.initials: J
authors.lastname: Madana
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Sir Mortimer B Davis Jewish General Hospital,McGill University,Montréal,Québec,Canada.
authors.forename: S D
authors.initials: SD
authors.lastname: Da Silva
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Sir Mortimer B Davis Jewish General Hospital,McGill University,Montréal,Québec,Canada.
authors.forename: M P
authors.initials: MP
authors.lastname: Hier
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Sir Mortimer B Davis Jewish General Hospital,McGill University,Montréal,Québec,Canada.
authors.forename: A M
authors.initials: AM
authors.lastname: Mlynarek
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Sir Mortimer B Davis Jewish General Hospital,McGill University,Montréal,Québec,Canada.
authors.forename: M J
authors.initials: MJ
authors.lastname: Black
mesh_terms: D000368:Aged; D002170:Canada; D015266:Carcinoma, Merkel Cell / Q000401:mortality* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology; D015996:Survival Rate
keywords: Head And Neck Neoplasms; Merkel Cell Carcinoma; Radiotherapy; Skin Neoplasms; Survival Analysis