Does regional lymph node status have a predictive effect on the prognosis of Merkel cell carcinoma

BACKGROUND There is no article that studies whether the regional lymph node (RLN) status affects the prognosis of Merkel cell carcinoma (MCC). METHODS The survival and disease data of MCC patients were obtained from the Surveillance, Epidemiological, and End Results (SEER) database. The overall survival (OS) and cause-specific survival (CSS) rates were endpoints. RESULTS A total of 1822 patients were included, with a mean age of 72.5 years. The number of RLN-positive patients was 862 (47.3%), and the number of RLN-negative patients was 960 (52.7%). The regression analysis showed that primary site, sex, and tumor size were statistically significant and independent predictors of RLN status. The five-year OS and CSS of RLN-negative patients were 71.4% and 92.3%, respectively, which were much higher than those of RLN-positive patients (37.5% and 65.8%, respectively) (P <0.001). In univariate survival analysis, positive RLN significantly predicted deterioration of OS and MSS (P <0.001). In multivariate analysis, RLN status had no statistically significant effect on patient prognosis. CONCLUSION The prognosis of patients with RLN metastasis is worse than that of patients without RLN metastasis, but RLN status is not an independent predictor of the prognosis of patients with MCC.