TOPLINE 

Patients with Merkel cell carcinoma (MCC) showed higher rates of hospitalization and critical care admission, poorer survival, and greater comorbidity burden than matched patients without MCC and had worse outcomes than several other cohorts with cancer.

METHODOLOGY  

• Researchers conducted a retrospective, single-enterprise cohort study using the Mayo Clinic Platform to compare outcomes and comorbidities among patients with MCC, those without MCC, and those with other types of cancer.
• A total of 1092 patients diagnosed with MCC (mean age, 72 years; 91.6% White; 83.8% non-Hispanic; 66.4% men) were matched with individuals without MCC and patients with other cancers, such as melanoma, lung cancer, colorectal cancer, breast/prostate cancer, glioblastoma, and cutaneous T-cell lymphoma.
• Outcomes included hospitalizations, critical care unit (CCU) admissions, overall mortality, and short-term (12-, 18-, and 24-month) and long-term (60- and 120-month) survival.

TAKEAWAY  

• Compared with matched patients without MCC, patients with MCC had higher hospitalization rates (53.5% vs 31.6%) and more CCU admissions (13.1% vs 7.3%; both P < .0001).
• Overall mortality was higher among patients with MCC than among those without the disease (P < .0001). Short- and long-term survival rates were lower among patients with MCC vs those without the disease: 82.7% vs 94.2% at 12 months, 78.0% vs 93.3% at 18 months, 73.5% vs 92.8% at 24 months, 58.5% vs 86.0% at 60 months, and 45.4% vs 73.8% at 120 months.
• Patients with MCC were more likely than those without MCC to have hematologic cancers or disorders; immunodeficiencies; skin cancers; other solid tumors; cardiovascular, hepatic, renal, and pulmonary diseases; and skin conditions (including actinic and seborrheic keratosis, skin fibrosis, and skin infections).
• MCC had worse outcomes than melanoma, breast, or prostate cancer and cutaneous T-cell lymphoma but better outcomes than lung cancer, colorectal cancer, and glioblastoma.

IN PRACTICE

“Our study supports that MCC is associated with decreased survival, increased morbidity, and increased healthcare utilization due to the higher comorbidity burden,” the authors wrote. “Few studies have compared healthcare utilization between MCC and other cancers, but none have investigated hospitalization rate, CCU admission rates, and survival outcomes in MCC versus other cancers.” 

SOURCE

The study was led by Sarah A. Amjad, BS, Mayo Clinic Alix School of Medicine, Jacksonville, Florida, and was published online on June 26 in JAAD International. 

LIMITATIONS

The study was limited to a single electronic health record database. Patients could not be propensity matched by immunosuppression status or disease stage, and the study could not distinguish among cancer-related hospitalizations or determine disease-specific mortality. 

DISCLOSURES

The authors reported no funding sources for this study. Several authors reported receiving investigator fees, consulting fees, and grants from drug companies, including Merck, DeepX Health, Leo Pharma, Mallinckrodt, Janssen, Boehringer Ingelheim, and Biocryst. One author disclosed holding patents related to cutaneous squamous cell carcinoma assessment, oral Janus kinase inhibitors in lichen planus, and topical ruxolitinib in lichen planus. Additional disclosures are noted in the original article. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.