Survival Outcomes in the Canadian Merkel Cell Carcinoma Population Between 2000 and 2018 and Descriptive Comparison with the American Joint Committee on Cancer 8th Edition Staging System—A Study from the Pan-Canadian Merkel Cell Collaborative
Bibliographic record
Abstract
Background/Objectives: Merkel cell carcinoma (MCC) is an uncommon but aggressive skin malignancy with a rising incidence. Limited data exist on the survival of MCC patients in Canada. This study analyzes the survival of patients diagnosed with MCC in Canada between 2000 and 2018 compared to those reported by the American Joint Committee on Cancer (AJCC) 8th edition. Risk factors included in the database were sex, age, and immunosuppression. Methods: We conducted a multicenter retrospective cohort study including patients diagnosed with stage I–IV MCC aged ≥18 from 10 Canadian university centers and three provinces. We evaluated differences in survival compared to the cohort included in the AJCC 8th edition. Results: Among 899 patients diagnosed with MCC in Canada, 327 (36.4%) had stage I, 195 (21.7%) had stage II, 305 (33.9%) had stage III, and 72 (8.0%) had stage IV at presentation. When examining risk factors, 61.1% (549) were male, 10.2% (92) were immunosuppressed, and age at diagnosis was 75 years (±11). The five-year overall survival for patients diagnosed in Canada at stage I was 56.8%, stage IIA 54.0%, stage IIB 28.0%, stage IIIA 52.7%, stage IIIB 40.2%, and stage IV 13.9%. Conclusions: Survival from MCC is low in Canada across all stages. Compared to the AJCC 8th edition, patients diagnosed with MCC in Canada have similar survival rates, except for patients diagnosed with stage IIIB, who have lower survival rates in the AJCC 8th edition. Further research is needed to improve the survival of this rare malignancy.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".