Merkel cell carcinoma in Turkey: A multicentric study Yildiz F, Demirci U, Küçükarda A, Büyüksimsek M, Sakalar T, Topcu TO, Aslan F, Tufan G, Aydin O, Turna H, Babacan NA, Basoglu T, Kurt B, Yildiz B, Eren T, Demiray AG, Gumusay O, Arslan C, Özdemir N, Urun Y, Baykara M, Turan N, Uysal M, Bilici A, Kavgaci H, Çiçin &, Kilickap S, Paydas S,

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Merkel cell carcinoma in Turkey: A multicentric study Fatih Yildiz¹, Umut Demirci¹, Ahmet Küçükarda², Mahmut Büyüksimsek³, Teoman Sakalar⁴, Turkan Ozturk Topcu⁵, Ferit Aslan¹, Gulnihal Tufan¹, Ovgu Aydin⁶, Hande Turna⁷, Nalan Akgul Babacan⁸, Tugba Basoglu⁸, Bediz Kurt⁹, Birol Yildiz¹⁰, Tülay Eren¹¹, Atike Gokcen Demiray¹², Ozge Gumusay¹³, Cagatay Arslan¹⁴, Nuriye Özdemir¹⁵, Yuksel Urun¹⁶, Meltem Baykara¹⁷, Nedim Turan¹⁸, Mukremin Uysal¹⁹, Ahmet Bilici²⁰, Halil Kavgaci⁵, İrfan Çiçin², Saadettin Kilickap²¹, Semra Paydas³ ¹ Department of Medical Oncology, Dr. A. Y. Ankara Oncology Research and Education Hospital, University of Health Sciences, Yenimahalle, Ankara, Turkey ² Department of Medical Oncology, Trakya University Faculty of Medicine, Edirne, Turkey ³ Department of Medical Oncology, Cukurova University Faculty of Medicine, Adana, Turkey ⁴ Department of Medical Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey ⁵ Department of Medical Oncology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey ⁶ Department of Pathology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey ⁷ Department of Medical Oncology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey ⁸ Department of Medical Oncology, Marmara University Faculty of Medicine, Istanbul, Turkey ⁹ Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey ¹⁰ Department of Medical Oncology, Gulhane Education and Research Hospital, University of Health Sciences, Ankara, Turkey ¹¹ Department of Medical Oncology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey ¹² Department of Medical Oncology, Faculty of Medicine, Pamukkale University, Denizli, Turkey ¹³ Department of Medical Oncology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey ¹⁴ Department of Medical Oncology, Medical Park Hospital, Izmir, Turkey ¹⁵ Department of Medical Oncology, Gazi University Faculty of Medicine, Ankara, Turkey ¹⁶ Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey ¹⁷ Department of Medical Oncology, Sakarya University Training and Research Hospital, Sakarya, Turkey ¹⁸ Department of Medical Oncology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey ¹⁹ Department of Medical Oncology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey ²⁰ Department of Medical Oncology, Medipol University, Medical Faculty, Istanbul, Turkey ²¹ Department of Medical Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey Correspondence Address: Fatih Yildiz, Department of Medical Oncology, Dr. A. Y. Ankara Oncology Research and Education Hospital, University of Health Sciences, Yenimahalle, Ankara Turkey Source of Support: None, Conflict of Interest: None DOI: 10.4103/jcrt.JCRT_950_19

Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine carcinoma of the skin. In this study, we aimed to evaluate the clinicopathologic characteristics, treatment outcomes, and survival of MCC cases in Turkey. Materials and Methods: The patients diagnosed with MCC between 1999 and 2018 at twenty different centers in Turkey were included in the study. Patient and tumor characteristics and adjuvant and metastatis treatment outcomes were analyzed retrospectively. Results: The median age of totally 89 patients was 70 (26–93). The most common primary location was lower limbs (n = 29, 32.5%). Immunohistochemically, CK20 positivity was present in 59 patients (66.3%). Only two patients had secondary malignancy. The majority of the patients (n = 76, 85.4%) were diagnosed at the localized stage. Surgery was performed for all patients in the early stage, and adjuvant radiotherapy or/and chemotherapy was applied to 52.6% (n = 40) of nonmetastatic patients. The median follow-up was 29 months. Recurrence developed in 21 (27.6%) of the 76 patients who presented with local or regional disease. Two-year disease-free survival (DFS) was 68.1% and 5-year DFS was 62.0% for localized stage. The 5-year DFS was similar for patients receiving adjuvant treatment (chemotherapy, radiotherapy, or sequential chemoradiotherapy) and without adjuvant therapy (P > 0.05). Two-year overall survival in patients who presented with localized disease was 71.3% and 18.5% in metastatic patients (P < 0.001). In the metastatic stage, platinum/etoposide combination was the most preferred combination regimen. Median progression-free survival (PFS) in first-line chemotherapy was 7 months (95% confidence interval: 3.5–10.5 months; standart error: 1.78). Conclusions: Although MCC is rare in Turkey, the incidence is increasing. Gender, CK20 status, tumor size, lymph node involvement, and adjuvant treatment were not associated with recurrence.

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    -  Yildiz F
    -  Demirci U
    -  Küçükarda A
    -  Büyüksimsek M
    -  Sakalar T
    -  Topcu TO
    -  Aslan F
    -  Tufan G
    -  Aydin O
    -  Turna H
    -  Babacan NA
    -  Basoglu T
    -  Kurt B
    -  Yildiz B
    -  Eren T
    -  Demiray AG
    -  Gumusay O
    -  Arslan C
    -  Özdemir N
    -  Urun Y
    -  Baykara M
    -  Turan N
    -  Uysal M
    -  Bilici A
    -  Kavgaci H
    -  Çiçin &
    -  Kilickap S
    -  Paydas S

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