Evidence map›Paper›PMID 27198511›Full record

ArticleAnnals of surgical oncology2016

Analysis of Prognostic Factors from 9387 Merkel Cell Carcinoma Cases Forms the Basis for the New 8th Edition AJCC Staging System.

Kelly L Harms, Mark A Healy, Paul Nghiem, Arthur J Sober, Timothy M Johnson, Christopher K Bichakjian, Sandra L Wong

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05594290 (Window-of-opportunity Study of Chemo-immunotherapy in Patients With Resectable Merkel Cell Carcinoma Prior to Surgery), which is not on this map. Cited by 233 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
233citing papers in PubMed, 5 pooled it
21.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05594290 phase2active not recruitingnot on this mapstarted 2022, after this paper: background citation

Window-of-opportunity Study of Chemo-immunotherapy in Patients With Resectable Merkel Cell Carcinoma Prior to Surgery: the MERCURY Trial

TypeinterventionalSponsorGruppo Oncologico del Nord-OvestRan2022 to 2026Enrolled36ConditionsMerkel Cell CarcinomaArmsRetifanlimab, Cisplatin, Etoposide
3 · Its place in the literature

Who cites it

233 citing papers in PubMed, 5 syntheses or guidelines pooled it, 534 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Paraneoplastic Neurologic Syndromes Associated With Merkel Cell Carcinoma.Neurology(R) neuroimmunology & neuroinflammation · 2024
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  12. Neoadjuvant Nivolumab for Patients With Resectable Merkel Cell Carcinoma in the CheckMate 358 Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020
    Trial
  13. Durable Tumor Regression and Overall Survival in Patients With Advanced Merkel Cell Carcinoma Receiving Pembrolizumab as First-Line Therapy.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2019
    Trial
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173 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Kelly L HarmsDepartment of Dermatology, University of Michigan Health System and Medical School, Ann Arbor, MI, USA. kharms@med.umich.edu.
Mark A HealyDepartment of Surgery, University of Michigan Health System and Medical School, Ann Arbor, MI, USA.
Paul NghiemDepartment of Medicine/Dermatology, University of Washington, Seattle, WA, USA.
Arthur J SoberDepartment of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Timothy M JohnsonDepartment of Dermatology, University of Michigan Health System and Medical School, Ann Arbor, MI, USA.
Christopher K BichakjianDepartment of Dermatology, University of Michigan Health System and Medical School, Ann Arbor, MI, USA.
Sandra L WongDepartment of Surgery, University of Michigan Health System and Medical School, Ann Arbor, MI, USA.
Michigan Medicine · USUniversity of Michigan–Ann Arbor · USFred Hutch Cancer Center · USHarvard University · US

Funding

University of Michigan Surgical Oncology Research Training ProgramT32CA009672 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI JACQUELINE SARA JERUSS, WEIPING ZOU · 1991 to 2026
$6.0M
NCI NIH HHS T32 CA009672
6 · The paper itself

Abstract

backgroundThe first consensus Merkel cell carcinoma (MCC) staging system was published in 2010. New information on the clinical course prompts review of MCC staging.

methodsA total of 9387 MCC cases from the National Cancer Data Base Participant User File with follow-up and staging data (1998-2012) were analyzed. Prognostic differences based on clinical and pathological staging were evaluated. Survival estimates were compared by disease extent.

resultsSixty-five percent of cases presented with local disease, whereas 26 and 8 % presented with nodal and distant disease. Disease extent at presentation was predictive of 5-year overall survival (OS) with estimates of 51, 35, and 14 % for local, nodal, and distant disease. Tumor burden at the regional nodal basin was predictive of 5-year OS with estimates of 40 and 27 % for clinically occult and clinically detected nodal disease. For local disease, we confirm improved prognosis when the regional nodal basin was negative by pathological compared with clinical staging. We identified 336 cases with clinically detected nodal disease and unknown primary tumor and showed improved prognosis over cases presenting with concurrent primary tumor (OS estimates of 42 vs. 27 %).

conclusionsAnalysis of a national dataset of MCC cases validates the predictive value of disease extent at presentation. Separation of clinical and pathological stage groups and regrouping of unknown primary tumors are supported by the analysis. The revised staging system provides more accurate prognostication and has been formally accepted by the AJCC staging committee for inclusion in the 8th edition.

Indexed as

AdultAgedAged, 80 and overCarcinoma, Merkel CellDatabases, FactualFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoplasm StagingNeoplasms, Unknown PrimaryPrognosisSkin NeoplasmsSurvival Rate

Identifiers

PMID27198511
PMCPMC8881989
OpenAlexW2407443857

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.