Improved survival in women versus men with Merkel cell carcinoma Journal Article


Authors: Tam, M.; Luu, M.; Barker, C. A.; Gharavi, N. M.; Hamid, O.; Shiao, S. L.; Nguyen, A. T.; Lu, D. J.; Ho, A. S.; Zumsteg, Z. S.
Article Title: Improved survival in women versus men with Merkel cell carcinoma
Abstract: Background: Studies have observed that women have better outcomes than men in melanoma, but less is known about the influence of sex differences on outcomes for other aggressive cutaneous malignancies. Objective: To investigate whether women and men have disparate outcomes in Merkel cell carcinoma (MCC). Methods: Patients with nonmetastatic MCC undergoing surgery and lymph node evaluation were identified from the National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier analysis and Cox proportional hazards regression models were used for overall survival, and competing-risks analysis and Fine-Gray models were used for cause-specific and other-cause mortality. Results: The NCDB cohort (n = 4178) included 1516 (36%) women. Women had a consistent survival advantage compared with men in propensity score–matched analysis (66.0% vs 56.8% at 5 years, P < .001) and multivariable Cox regression (hazard ratio, 0.68; 95% confidence interval, 0.61-0.75; P < .001). Similarly, women had a survival advantage in the SEER validation cohort (n = 1202) with 457 (38.0%) women, which was entirely due to differences in MCC-specific mortality (5-year cumulative incidence: 16.4% vs 26.7%, P = .002), with no difference in other-cause mortality (16.8% vs 17.8%, P = .43) observed in propensity score–matched patients. Limitations: Potential selection bias from a retrospective data set. Conclusion: In MCC, women have improved survival compared with men, driven by MCC-related mortality. © 2020 American Academy of Dermatology, Inc.
Keywords: sex; seer; national cancer data base; ncdb; merkel cell cancer
Journal Title: Journal of the American Academy of Dermatology
Volume: 84
Issue: 2
ISSN: 0190-9622
Publisher: Mosby Elsevier  
Date Published: 2021-02-01
Start Page: 321
End Page: 329
Language: English
DOI: 10.1016/j.jaad.2020.02.034
PUBMED: 32423829
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 1 February 2021 -- Source: Scopus
Altmetric
Citation Impact
MSK Authors
  1. Christopher Barker
    163 Barker