The following is a summary of “Merkel cell carcinoma recurrence risk estimation is improved by integrating factors beyond cancer stage: A multivariable model and web-based calculator,” published in the March 2024 issue of Dermatology by McEvoy, et al.
Merkel cell carcinoma (MCC) poses a significant recurrence risk, with up to 40% of patients experiencing recurrence. Various factors, including stage, sex, immunosuppression, unknown primary status, age, site of primary tumor, and time since diagnosis, influence this risk. For a study, researchers sought to develop a multivariable model and web-based calculator to predict MCC recurrence risk better than stage alone.
Data from a prospective cohort of 618 patients were analyzed using competing risk regression to estimate recurrence risk based on stage and additional factors.
The multivariable model identified several impactful recurrence risk factors, including American Joint Committee on Cancer stage (P < .001), immunosuppression (hazard ratio 2.05; P < .001), male sex (1.59; P = .003), and unknown primary (0.65; P = .064). Compared to using stage alone, the model improved prognostic accuracy (concordance index for 2-year risk, 0.66 vs 0.70; P < .001) and modified estimated recurrence risk by up to 4-fold (18% for low-risk stage IIIA vs 78% for high-risk IIIA over 5 years).
The multivariable model highlighted the importance of integrating factors beyond the stage for accurate recurrence risk prediction in MCC. The development of an online calculator based on this model (available at merkelcell.org/recur) incorporates time since diagnosis and provides valuable data for optimizing surveillance strategies for MCC patients.