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Immune Status in Merkel Cell Carcinoma: Relationships With Clinical Factors and Independent Prognostic Value.
Yusuf, Mehran B; Gaskins, Jeremy; Rattani, Abbas; McKenzie, Grant; Mandish, Steven; Wall, Weston; Farley, Alyssa; Tennant, Paul; Bumpous, Jeffrey; Dunlap, Neal.
Afiliación
  • Yusuf MB; Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA. mehran.yusuf@louisville.edu.
  • Gaskins J; Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA.
  • Rattani A; Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA.
  • McKenzie G; Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA.
  • Mandish S; Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA.
  • Wall W; Department of Dermatology, Medical College of Georgia, Augusta, GA, USA.
  • Farley A; Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA.
  • Tennant P; Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville Hospital, Louisville, KY, USA.
  • Bumpous J; Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville Hospital, Louisville, KY, USA.
  • Dunlap N; Department of Radiation Oncology, University of Louisville School of Medicine, Louisville, KY, USA.
Ann Surg Oncol ; 28(11): 6154-6165, 2021 Oct.
Article en En | MEDLINE | ID: mdl-33852099
BACKGROUND: Immunosuppression (IS) currently is not considered in staging for Merkel cell carcinoma (MCC). An analysis of the National Cancer Database (NCDB) was performed to investigate immune status as an independent predictor of overall survival (OS) for patients with MCC and to describe the relationship between immune status and other prognostic factors. METHODS: The NCDB was queried for patients with a diagnosis of MCC from 2010 to 2016 who had known immune status. Multivariable Cox proportional hazards models were used to define factors associated with OS. Secondary models were constructed to assess the association between IS etiology and OS. Multivariable logistic regression models were used to characterize relationships between immune status and other factors. RESULTS: The 3-year OS was lower for the patients with IS (44.6%) than for the immunocompetent (IC) patients (68.7%; p < 0.0001). Immunosuppression was associated with increased adjusted mortality hazard (hazard ratio [HR], 2.36, 95% confidence interval [CI], 2.03-2.75). The etiology of IS was associated with OS (p = 0.0015), and patients with solid-organ transplantation had the lowest 3-year OS (32.7%). Immunosuppression was associated with increased odds of greater nodal burden (odds ratio [OR], 1.70; 95% CI, 1.37-2.11) and lymphovascular invasion (OR, 1.58; 95% CI, 1.23-2.03). CONCLUSIONS: Immune status was independently prognostic for the OS of patients with localized MCC. The etiology of IS may be associated with differential survival outcomes. Multiple adverse prognostic factors were associated with increased likelihood of IS. Immune status, and potentially the etiology of IS, may be useful prognostic factors to consider for future MCC staging systems.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Cutáneas / Carcinoma de Células de Merkel Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Cutáneas / Carcinoma de Células de Merkel Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos