Journal of the American Academy of Dermatology · 2025
Disparities in survival and tumor characteristics in patients with single and multiple primary Merkel cell carcinomas.
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Luo Zehao, Sun Yuming, Guo Ziyu, Le Jiayuan, Zhang Shiyu, Yu Yao, Xu Shengchao, Zeng Furong, Deng Guangtong
Аннотация
BACKGROUND: Patients with Merkel cell carcinoma (MCC) are at risk of developing a subsequent primary MCC, but its profile and survival impact remain unclear.
OBJECTIVES: To describe the epidemiologic profile and evaluate the prognosis of patients with multiple primary Merkel cell carcinoma (MPMCC).
METHODS: This retrospective cohort study used data from the Surveillance, Epidemiology, and End Results Program (2004-2021). Standardized incidence ratios were calculated to estimate the risk of subsequent MCC. Multivariable Cox models with a time-varying covariate were applied to compare survival between patients with single and multiple primary MCC.
RESULTS: Of 9536 patients with MCC, 130 (1.4%) developed MPMCC. MCC survivors had a nearly 60-fold increased risk of subsequent MCC (standardized incidence ratio = 61.8; 95% confidence interval [CI], 50.2-75.3), with 78.5% diagnosed with a second primary MCC within 5 years. In patients with MPMCC, the median tumor size decreased from 20.0 mm at first diagnosis to 15.0 mm at the second (P = .038). MPMCC was associated with worse overall (hazard ratio = 1.64; 95% CI, 1.31-2.05) and cancer-specific survival (hazard ratio = 2.64; 95% CI, 1.91-3.65).
LIMITATIONS: Retrospective design and potential misclassification of MPMCC.
CONCLUSIONS: MPMCC is associated with significantly worse overall and cancer-specific survival, supporting the need for intensified follow-up strategies.
OBJECTIVES: To describe the epidemiologic profile and evaluate the prognosis of patients with multiple primary Merkel cell carcinoma (MPMCC).
METHODS: This retrospective cohort study used data from the Surveillance, Epidemiology, and End Results Program (2004-2021). Standardized incidence ratios were calculated to estimate the risk of subsequent MCC. Multivariable Cox models with a time-varying covariate were applied to compare survival between patients with single and multiple primary MCC.
RESULTS: Of 9536 patients with MCC, 130 (1.4%) developed MPMCC. MCC survivors had a nearly 60-fold increased risk of subsequent MCC (standardized incidence ratio = 61.8; 95% confidence interval [CI], 50.2-75.3), with 78.5% diagnosed with a second primary MCC within 5 years. In patients with MPMCC, the median tumor size decreased from 20.0 mm at first diagnosis to 15.0 mm at the second (P = .038). MPMCC was associated with worse overall (hazard ratio = 1.64; 95% CI, 1.31-2.05) and cancer-specific survival (hazard ratio = 2.64; 95% CI, 1.91-3.65).
LIMITATIONS: Retrospective design and potential misclassification of MPMCC.
CONCLUSIONS: MPMCC is associated with significantly worse overall and cancer-specific survival, supporting the need for intensified follow-up strategies.