Endocrine Abstracts

Introduction: Merkel cell carcinoma is a rare and aggressive neuroendocrine skin cancer. It is characterized by a high rate of local recurrence after surgical resection as well as the occurrence of distant metastases. It mostly occurs in the elderly and the exact etiology is unknown. The most significant risk factors for its occurrence are exposure to ultraviolet light and the oncogenic effect of the Merkel cell polyoma virus.

Aim: Demographic and clinical characterization of patients with Merkel cell carcinoma as well as tumor characteristics and their impact on the outcome of the disease.

Methods: The retrospective study included 37 patients diagnosed with Merkel cell carcinoma who were treated in our department between 2001 and 2022.

Results: Most patients were male, 64.9%, while the average age at the time of diagnosis was 62.03±12.03 years. The median follow-up of patients from the time of diagnosis was 24 (5–121) months. The primary site of the tumor was unknown in 32.4% of patients, while localization in the head and neck, upper extremities, lower extremities, and glutes was 12.9%, 19.4%, 12.9%, and 16.1%, respectively. Metastatic disease at the time of diagnosis was verified in 64.9% of patients, most often in locoregional lymph nodes 61.1%. In stage I the disease was diagnosed in 17.1% of patients, in stage II in 14.3%, stage III in 57.1% and stage IV in 11.4% of patients. Systemic chemotherapy was used in 82.9%, locoregional radiation therapy in 34.3%, and immunotherapy in 16.2% of patients. Survival was statistically significantly shorter in patients with stage III and IV disease compared to patients with stage I and II disease (P 0.04). The earliest death occurred 5 months after diagnosis. A trend in shorter survival was observed in male patients (P 0.06).

Conclusion: Advanced Merkel cell carcinoma is associated with a worse prognosis. The fact that in most patients at the time of diagnosis there is locoregional dissemination of the disease imposes the need for a greater degree of clinical suspicion among doctors of various specialties, as well as raising public awareness of this type of cancer with the aim of early diagnosis and treatment.