p-ALK positivity had more impact on MCC-specific survival compared to ALK positivity (HR 0.25, 95% CI 0.068–0.87 and P = 0.032 for p-ALK and HR 0.39, 95% CI 0.17–0.88 and P = 0.023 for ALK). Here, ALK is linked to Merkel cell skin cancer.