Merkel Cell Carcinoma of the Skin: Deducing the Pattern of Spread from an International Aggregated Database of 303 Patients
Bibliographic record
Abstract
Background: There is controversy if Merkel cell carcinomas (MCCs) spread to lymph nodes or distant metastases (DM) first. Methods: Data from six institutions (March 1982 to Feb 2015) formed an aggregated database of 303 patients. The primary outcome was recurrence patterns. Results: (a) More patients presented with lymph node metastases (LNM) than DM, 19.5% (59/303) versus 2.6% (8/303). (b) 26.1% (79/303) had lifetime DM, of whom 47/79 also developed LNM: 31/47 (66%) prior to DM. (c) A shorter median time interval of 1.5 (range: 0-47.0) months from initial diagnosis to LNM; and 8 (0-107.8) months from diagnosis to DM. Another additional observation was 7/79 patients with initial primaries <1 cm in maximum dimension developed DM in their lifetime, the smallest being 0.2 cm. Conclusions: Three observations favor prior LNM giving rise to subsequent DM as the main pathway of dissemination in MCC. These observations are especially important in developing countries with inadequate staging resources for patient management. Even small MCCs <1 cm in maximum dimension, including a 0.2 cm primary, can metastasize. Therefore, we believe this report might be practice-changing since some thought these small primaries do not require any adjuvant therapy.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".