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Merkel Cell Polyomavirus Antibody Titer Predicts Recurrence-Free Survival

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Abstract

Background

Merkel cell polyomavirus (MCPyV) is associated with the development of Merkel cell carcinoma (MCC). Antibody (MCPyV-Ab) titers may have prognostic implications. This study evaluated the impact of the presence or absence of MCPyV-Ab on the 2-year overall survival (OS) and disease-free survival (DFS) of MCC patients.

Methods

This single-center, IRB-approved, retrospective cohort study evaluated 51 adult patients with MCC from 2014 to 2021 using a prospectively maintained database. Patients were compared by MCPyV-Ab status, and Kaplan-Meier analysis was used to evaluate 2-year OS and DFS.

Results

Of the 51 patients, 13 (25.4%) were seropositive, 41 (80.4%) underwent wide excision, 40 (80.0%) received radiotherapy, and 43 (84.3%) received multimodal therapy. The median follow-up period was 15.5 months (range 1–69.5 months). The median 2-year OS of the entire cohort was not reached. The median 2-year OS was not reached for either the seronegative or the seropositive patients. The difference in 2-year OS between the groups was not statistically significant (p = 0.37). Eight patients, all seronegative, were never rendered disease-free and were removed from recurrence analysis. The seropositive patients experienced no recurrences. Of the 30 seronegative patients, 9 (30.0%) experienced recurrence. The median 2-year DFS of the entire cohort was not reached. The median 2-year DFS of the seronegative group was 22.2 months. The 2-year DFS was not reached for the seropositive cohort. Seropositivity conferred a significantly better 2-year DFS than seronegativity (p = 0.04).

Conclusion

The MCPyV-Ab seropositive patients demonstrated improved 2-year DFS. The seropositive patients showed a strong trend toward improved 2-year OS, although the difference not statistically significant. This study substantiated the value of MCPyV-Ab assessment for MCC.

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Authors and Affiliations

  1. University Surgical Oncology, University of Tennessee, Knoxville, TN, USA

    James M. Lewis MD, FACS, FSSO, James M. McLoughlin MD, FACS, FSSO & Laura M. Enomoto MD, MSc, FACS, FSSO

  2. Martin Health Physician Group, Cleveland Clinic, Port St. Lucie, FL, USA

    Miles Landry MBBS

  3. Department of Surgery, University of Tennessee, UT Graduate School of Medicine, Knoxville, TN, USA

    Aaron J. Arroyave MD, James M. Lewis MD, FACS, FSSO, James M. McLoughlin MD, FACS, FSSO & Laura M. Enomoto MD, MSc, FACS, FSSO

Authors
  1. Aaron J. Arroyave MD
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  2. James M. Lewis MD, FACS, FSSO
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  3. Miles Landry MBBS
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  4. James M. McLoughlin MD, FACS, FSSO
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  5. Laura M. Enomoto MD, MSc, FACS, FSSO
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Correspondence to Laura M. Enomoto MD, MSc, FACS, FSSO.

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Arroyave, A.J., Lewis, J.M., Landry, M. et al. Merkel Cell Polyomavirus Antibody Titer Predicts Recurrence-Free Survival. Ann Surg Oncol 29, 1620–1626 (2022). https://doi.org/10.1245/s10434-021-11008-8

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  • DOI: https://doi.org/10.1245/s10434-021-11008-8

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