Survival of Patients With Head and Neck Merkel Cell Cancer: Findings From the Pan-Canadian Merkel Cell Cancer Collaborative.
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Nayak Ameeta Lubina, Pickett Arthur Travis, Delisle Megan, Dingley Brittany, Mallick Ranjeeta, Hamilton Trevor, Stuart Heather, Talbot Martha, McKinnon Gregory, Jost Evan, Thiboutot Eva, Francescutti Valerie, Samman Sal, Easson Alexandra, Schellenberg Angela, Merchant Shaila, La Julie, Vanderbeck Kaitlin, Wright Frances, Berger-Richardson David, Hebbard Pamela, Hershorn Olivia, Younan Rami, Patocskai Erica, Rodriguez-Qizilbash Samuel, Meguerditichian Ari, Tchuente Vanina, Kazandjian Suzanne, Mathieson Alex, Hossain Farisa, Hetu Jessika, Corsten Martin, Tohmé Angelina, Nessim Carolyn, Johnson-Obaseki Stephanie
Аннотация
OBJECTIVE: To evaluate the overall survival (OS) of patients in Canada with head and neck MCC (HNMCC) according to American Joint Committee on Cancer 8th edition staging and treatment modalities.
DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study of 400 patients with a diagnosis of HNMCC between July 1, 2000, and June 31, 2018, was conducted using the Pan-Canadian Merkel Cell Cancer Collaborative, a multicenter national registry of patients with MCC. Statistical analyses were performed from January to December 2022.
MAIN OUTCOMES AND MEASURES: The primary outcome was 5-year OS. Multivariable analysis using a Cox proportional hazards regression model was performed to identify factors associated with survival.
RESULTS: Between 2000 and 2018, 400 patients (234 men [58.5%]; mean [SD] age at diagnosis, 78.4 [10.5] years) with malignant neoplasms found in the face, scalp, neck, ear, eyelid, or lip received a diagnosis of HNMCC. At diagnosis, 188 patients (47.0%) had stage I disease. The most common treatment overall was surgery followed by radiotherapy (161 [40.3%]), although radiotherapy alone was most common for stage IV disease (15 of 23 [52.2%]). Five-year OS was 49.8% (95% CI, 40.7%-58.2%), 39.8% (95% CI, 26.2%-53.1%), 36.2% (95% CI, 25.2%-47.4%), and 18.5% (95% CI, 3.9%-41.5%) for stage I, II, III, and IV disease, respectively, and was highest among patients treated with surgery and radiotherapy (49.9% [95% CI, 39.9%-59.1%]). On multivariable analysis, patients treated with surgery and radiotherapy had greater OS compared with those treated with surgery alone (hazard ratio [HR], 0.76 [95% CI, 0.46-1.25]); however, this was not statistically significant. In comparison, patients who received no treatment had significantly worse OS (HR, 1.93 [95% CI, 1.26-2.96)].
CONCLUSIONS AND RELEVANCE: In this cohort study of the largest Canada-wide evaluation of HNMCC survival outcomes, stage and treatment modality were associated with survival. Multimodal treatment was associated with greater OS across all disease stages.