Merkel Cell Carcinoma: Do Women Have Better Outcomes Than Men?
Posted: Monday, August 10, 2020
The aggressive and rare Merkel cell carcinoma seems to affect men at twice the rate of women. For patients with melanoma, men appear to have poorer survival outcomes compared with women, although this pattern had yet to be observed in Merkel cell carcinoma. In a retrospective study by Zachary S. Zumsteg, MD, of Cedar-Sinai Medical Center in Los Angeles, and colleagues, women with Merkel cell carcinoma had better survival than men. Results were published in the Journal of the American Academy of Dermatology.
“The female survival advantage is entirely driven by Merkel cell carcinoma–related mortality and not by competing causes of mortality,” the investigators commented. “More research is needed to investigate the underlying biological and immunologic differences that may account for this survival difference.”
Study authors focused on data from the National Cancer database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) database, identifying patients with nonmetastatic Merkel cell carcinoma who underwent surgery with lymph node evaluation. Analyses were conducted separately for each database.
A total of 4,178 patients were in the NCDB cohort, and 1,516 of them (36%) were women. Overall survival was significantly better for women than men in this cohort (hazard ratio = 0.68; P < .001), with a 5-year overall survival of 66.0% in women and 56.8% in men (P < .001). The SEER cohort included 1,202 patients, and 457 of them (38%) were women. Similar to the other cohort, the 5-year overall survival was better in women than in men (66.9% vs. 55.5%; P = .001), and improved overall survival was correlated with female sex (hazard ratio = 0.68; P < .001). Furthermore, when propensity score matching was used to control for confounding variables, there was a higher 5-year mortality for men with this type of skin cancer at 26.7% than for women at 16.4% (P < .001).
Disclosure: For full disclosure of the study authors, visit jaad.org.