The recurrence rate for Merkel cell carcinoma (MCC) is about 40 percent, and most recurrence occurs within the first three years, according to a study published online Feb. 23 in JAMA Dermatology .

Aubriana M. McEvoy, M.D., from the University of Washington in Seattle, and colleagues estimated the risk for stage-specific MCC recurrence and mortality in a prospective study involving 618 patients enrolled between 2003 and 2019; 233 experienced MCC recurrence.

The researchers found that the five-year recurrence rate was 40 percent. The risk for recurrence was high in the first year (11, 33, 30, 45, and 58 percent for pathologic stage I, IIA/IIB, IIIA, IIIB, and IV, respectively); overall, 95 percent of the recurrences occurred within the first three years. Living patients were followed for a median of 4.3 years. In univariate analyses, factors associated with increased recurrence risk, beyond stage, included immunosuppression, male sex, known primary lesion among patients with clinically detectable nodal disease, and older age. Sixty-five percent of the 187 deaths in the cohort were due to MCC. MCC-specific survival was strongly dependent on stage and was 95 versus 41 percent at five years for patients with pathologic stage I versus IV. Local recurrence did not appreciably reduce survival compared with no recurrence among patients presenting with stage I to II MCC (85 versus 88 percent MCC-specific survival at five years).

"A multivariate tool combining stage, age, sex, immune suppression, and unknown primary status would offer a more accurate recurrence risk estimate and is in development," the authors write.

Several authors disclosed financial ties to the pharmaceutical and health care industries; one author disclosed pending patents.

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