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Home Oncology New Model Improves Prognosis for Merkel Cell Carcinoma


NEW MODEL IMPROVES PROGNOSIS FOR MERKEL CELL CARCINOMA

14 Dec 2024
Oncology
View All News


A recent study has shed light on improving the prognostication of Merkel cell
carcinoma (MCC), a rare and aggressive form of skin cancer. The study, which
analysed data from 10,958 patients with histologically confirmed MCC between
January 2000 and December 2020, aimed to determine the most effective survival
endpoint for predicting patient outcomes and to develop a model for more
accurate survival predictions. 

The study compared two survival endpoints: disease-specific death (DSD) and
overall survival (OS), finding that DSD provided greater discriminatory power
for stratification according to the American Joint Committee on Cancer (AJCC)
8th edition staging criteria. 

A multivariable model, using the Fine and Gray Competing Risk approach, was then
developed to improve predictions. The analysis revealed that certain factors had
a significant impact on DSD, including truncal lesions, age over 84 years, male
sex, and marital status. Notably, these factors enhanced survival predictions
when incorporated into a new model. The model’s performance improved the
predictive accuracy in both a U.S. cohort (C-index of 0.75 vs. 0.64) and an
external UK cohort (C-index of 0.77), surpassing current MCC staging systems. 

The findings emphasise the importance of refining staging criteria to better
predict outcomes for MCC patients and suggest that incorporating additional
patient and tumour features could significantly improve prognostication. These
insights could lead to more tailored treatment strategies and improved patient
care. 

Helena Bradbury, EMJ 

 

Reference 

Andrew TW et al. A multivariable disease specific model enhances prognostication
beyond current Merkel cell carcinoma staging: an international cohort study of
10,958 patients. 2024:S0190-9622(24)03232-8.  

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