Evidence map›Paper›PMID 40647550›Full record

ReviewCancers2025

Merkel Cell Carcinoma: An Updated Review Focused on Bone and Bone Marrow Metastases.

Biagio Scotti, Elisabetta Broseghini, Costantino Ricci, Barbara Corti, Costanza Viola, Cosimo Misciali, Carlotta Baraldi, Sabina Vaccari, Martina Lambertini, Federico Venturi and 10 more

Abstract readReview
In one paragraph

Review in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. EmergingFrontiers in cell and developmental biology · 2025
    Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Biagio ScottiDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.ORCID 0000-0001-7461-1726
Elisabetta BroseghiniIRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.ORCID 0000-0002-7401-9842
Costantino RicciPathology Unit, DIAP-Dipartimento InterAziendale di Anatomia Patologica di Bologna, Maggiore Hospital AUSL Bologna, 40133 Bologna, Italy.ORCID 0000-0001-7254-4195
Barbara CortiPathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Costanza ViolaDivision of Cardiovascular and Interventional Radiology, Medical University of Vienna, 1090 Vienna, Austria.
Cosimo MiscialiDermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Carlotta BaraldiDermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Sabina VaccariDermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Martina LambertiniDermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.ORCID 0000-0003-4282-342X
Federico VenturiDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.ORCID 0000-0001-5053-4172
Elisabetta MagnaterraDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.ORCID 0000-0002-3263-4353
Aurora AlessandriniDermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Tiziano FerrariDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.
Massimo LepriDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.
Gabriele ArgenzianoDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.
Barbara MelottiOncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Elena CampioneDermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.ORCID 0000-0001-7447-6798
Davide CampanaDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.ORCID 0000-0002-4615-7340
Manuela FerracinDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.ORCID 0000-0002-1595-6887
Emi DikaDepartment of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy.ORCID 0000-0003-3186-2861

Funding

Finanziato dall'Unione Europea - NextGenerationEU a valere sul Piano Nazionale di Ripresa e Resilienza (PNRR) - Missione 4 Istruzione e ricerca - Componente 2 Dalla ricerca all'impresa - Investimento 1.1, Avviso Prin2022 indetto con DD N. 104 del 2/2/2022 J53D23003260006
6 · The paper itself

Abstract

BACKGROUND/

objectivesDespite advancements in early diagnosis and clinical practices guided by standardized care protocols, Merkel cell carcinoma (MCC) is marked by an unfavorable prognosis with a 5-year relative survival rate of 65%, based primarily on data collected prior to the introduction of immunotherapy. Regional nodal metastases affect 40-50% of MCC patients, while approximately 33% experience distant dissemination. Among these, bone and bone marrow metastases are particularly notable, although the characteristics and clinical implications of this metastatic disease in MCC remain poorly understood.

methodsA comprehensive review was conducted using the Medline database (via PubMed) up to January 2025. The search strategy included the string "(Merkel cell carcinoma AND (bone OR marrow))".

resultsA total of 1133 (69.3% male and 30.7% female) patients diagnosed with advanced MCC were collected. The median (IQR) age at diagnosis was 67.5 (12.65) years old. Overall, 201 (20.8%) cases of bone and/or bone marrow metastases were identified and linked to a primary known MCC in 75.7% of cases. Bone metastases (BMs) appear as the third most common metastatic site, following the liver (second) and lymph nodes (first). They show mixed biological and radiological behavior, with a marked preference for the axial skeleton over the appendicular one. Addressing the characteristics of metastatic bone disease, neurological symptoms were the most documented, whereas bone marrow involvement and leukemic spread seemed to be primarily related to immunosuppression. Multimodal treatment strategies, including platinum-based chemotherapy and radiotherapy, were the primary approaches adopted, reflecting therapeutic practices from the pre-immunotherapy era.

conclusionsThe pattern of metastatic spread in MCC differs among studies, with the bones resulting as the third most common site of distant spread. Excluding head and neck MCC, which seems to be more regularly associated with liver metastases, the relationship between the primary tumor site and the development of bone or bone marrow metastases appears inconsistent. Overall, BMs mostly correlated with advanced MCC stages and poorer survival outcomes, with a median overall survival (OS) of 8 months (range 12.75-4). The integration of international guidelines, evolving evidence from clinical trials, and the expanding role of immune checkpoint inhibitors (ICIs) will contribute to improving systemic disease control and enhance patient care.

Indexed as

bonebone marrowdermoscopydiagnosisetiologyMCCMCCUPMerkel cell carcinomametastasisoriginradiotherapyRCMreflectance confocal microscopytherapytreatment

Identifiers

PMID40647550
PMCPMC12248508

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.