Evidence map›Paper›PMID 42050004›Full record

ArticleJournal of cancer research and clinical oncology2026

General health versus tumor stage: determinants of survival in Merkel cell carcinoma assessed by sentinel lymph node biopsy.

Thilo Gambichler, Ekaterina Heinzer, Nessr Abu Rached, Hans-Joachim Schulze, Kirsten Noah, Silke C Hofmann, Ulrich Wesselmann, Ralf Gutzmer, Stefanie Boms, Laura Susok and 6 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of cancer research and clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

16 authors.

Thilo Gambichler *Department of Dermatology, Dortmund Hospital gGmbH, University of Witten/Herdecke, Dortmund, Germany. thilo.gambichler@klinikumdo.de.
Ekaterina Heinzer *Department of Dermatology, Christian Hospital Unna, Unna, Germany.
Nessr Abu RachedDepartment of Dermatology, Skin Cancer Center, Ruhr-University Bochum, Bochum, Germany.
Hans-Joachim SchulzeDepartment of Dermatology and Dermato-Histo-Pathology, Skin Cancer Center, Fachklinik Hornheide, Münster, Germany.
Kirsten NoahDepartment of Dermatology and Dermato-Histo-Pathology, Skin Cancer Center, Fachklinik Hornheide, Münster, Germany.
Silke C HofmannCenter for Dermatology, Allergology and Dermatosurgery, Helios University Hospital Wuppertal, University of Witten/Herdecke, Wuppertal, Germany.
Ulrich WesselmannCenter for Dermatology, Allergology and Dermatosurgery, Helios University Hospital Wuppertal, University of Witten/Herdecke, Wuppertal, Germany.
Ralf GutzmerDepartment of Dermatology, Johannes Wesling Medical Center Minden, Ruhr University Bochum, Minden, Germany.
Stefanie BomsDepartment of Dermatology, Christian Hospital Unna, Unna, Germany.
Laura SusokDepartment of Dermatology, Dortmund Hospital gGmbH, University of Witten/Herdecke, Dortmund, Germany.
Sera S Weyer-FahlbuschDepartment of Dermatology, Dortmund Hospital gGmbH, University of Witten/Herdecke, Dortmund, Germany.
Alexander KreuterDepartment of Dermatology, Venereology and Allergology, University of Witten/Herdecke, HELIOS St. Elisabeth Hospital Oberhausen, Oberhausen, Germany.
Julia HyunDepartment of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, University of Witten/Herdecke, Duisburg, Germany.
Valentina L MüllerDepartment of Dermatology, Venereology, and Allergology, Helios St. Johannes Hospital Duisburg, University of Witten/Herdecke, Duisburg, Germany.
Rosanna AuerDepartment of Dermatology, Christian Hospital Unna, Unna, Germany.
Jürgen C BeckerDepartments of Translational Skin Cancer Research and Dermatology, University Hospital Essen, Essen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOverall survival (OS) of Merkel cell carcinoma (MCC) patients is strongly influenced by health. Sentinel lymph node biopsy (SLNB) is recommended for staging. We evaluated whether SLNB is associated with OS in clinically node-negative MCC and contrasted tumor factors with patient frailty.

methodsSTROBE-compliant cohort across eight centers in Germany (2004–2024). We included 271 primary stage I–II MCC; 167 underwent SLNB and 104 did not. The primary outcome was OS; disease-specific survival (DSS) and progression-free probability (PFP) were secondary. Kaplan–Meier and Cox models were used. Confounding by indication was addressed with 1:1 propensity score matching and sensitivity analyses.

resultsPatients receiving SLNB were younger (median 74 vs 82 years; p < 0.001) and less comorbid (Charlson 4 vs 5). Ten-year OS was 69.5% with SLNB versus 45.2% without (log-rank p < 0.0001); unadjusted HR 0.34 (95% CI 0.20–0.59). In the matched cohort, SLNB remained associated with lower all-cause mortality (HR 0.56, 95% CI 0.34–0.93; p = 0.024). DSS did not differ (HR 1.09, 95% CI 0.55–2.13;  p= 0.81). For PFP, unadjusted curves favored SLNB (p=0.0045), but the matched analysis was not significant (HR 0.53, 95% CI 0.23–1.26). Sensitivity analyses suggested benefit: overlap weighting HR 0.49 (95% CI 0.33–0.73; p = 0.00045) and a stage-restricted match HR 0.36 (95% CI 0.13–0.99; p= 0.048).

conclusionsSLNB was associated with improved OS after adjustment, supporting its role in staging and risk stratification. The absence of DSS and matched PFP differences highlights the influence of overall health; residual confounding by indication cannot be excluded.

Indexed as

Carcinoma, Merkel CellSentinel Lymph Node BiopsySkin NeoplasmsAgedAged, 80 and overFemaleGermanyHumansMaleNeoplasm StagingNon-Melanoma Skin NeoplasmsPrognosisCancerElderlyPerformance statusPrognosis

Identifiers

PMID42050004
PMCPMC13125591

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.