Grabowski Julia, Saltzstein Sidney L, Sadler Georgia Robins, Tahir Zunera, Blair Sarah
Department of Family and Preventive Medicine, University of California at San Diego School of Medicine, La Jolla, CA.
Clin Med Oncol. 2008;2:327-33. doi: 10.4137/cmo.s423. Epub 2008 Apr 1.
Melanoma and Merkel cell carcinoma (MCC) are both aggressive skin malignancies associated with immunosuppression and possible UV exposure. Both tumors get similar surgical treatment; however, MCC is a relatively rare tumor in which less is known about prognosis and clinical behavior.
The California Cancer Registry (CCR), a population-based registry, was reviewed from the years 1988-2003. Merkel cell carcinoma and melanoma were compared with relation to gender, age, ethnicity, disease stage, site, and survival.
A total of 113,187 cases of melanoma and 1,878 cases of MCC were identified in the CCR. Though both cancers are more common in men than in women, MCC had a higher incidence in men than melanoma (63% vs 57% p < 0.005). MCC occurs in the more elderly, with 73.6% of cases occurring in people over 70 years. In contrast, 69% of melanoma cases occurred in people younger than 70 years (p < 0.005). MCC shows a predilection for the head and neck compared to melanoma (47% vs 25.8%) Additionally, melanoma occurs more frequently on the trunk than MCC (30% vs 8.7%). Finally, the 10-year cumulative survival is lower for MCC than for melanoma (17.7% vs 61.3%, p < 0.005).
Many clinicians assume MCC and melanoma behave similarly. However, MCC occurs in an older population, more frequently on the head and neck, in a higher percentage of men. Additionally, MCC has a higher rate of regional metastasis and thus may have more of a benefit from regional staging procedures. Overall, MCC has a worse prognosis.
黑色素瘤和默克尔细胞癌（MCC）均为侵袭性皮肤恶性肿瘤，与免疫抑制及可能的紫外线暴露相关。两种肿瘤的手术治疗方式相似；然而，MCC是一种相对罕见的肿瘤，其预后和临床行为方面的了解较少。
对基于人群的加利福尼亚癌症登记处（CCR）1988年至2003年的数据进行回顾。比较了默克尔细胞癌和黑色素瘤在性别、年龄、种族、疾病分期、部位及生存率方面的情况。
在CCR中，共识别出113187例黑色素瘤病例和1878例MCC病例。尽管两种癌症在男性中均比在女性中更常见，但MCC在男性中的发病率高于黑色素瘤（63%对57%，p<0.005）。MCC多见于老年人，73.6%的病例发生在70岁以上人群。相比之下，69%的黑色素瘤病例发生在70岁以下人群（p<0.005）。与黑色素瘤相比，MCC更倾向于发生在头颈部（47%对25.8%）。此外，黑色素瘤在躯干上的发生频率高于MCC（30%对8.7%）。最后，MCC的10年累积生存率低于黑色素瘤（17.7%对61.3%，p<0.005）。
许多临床医生认为MCC和黑色素瘤的行为相似。然而，MCC发生于老年人群，更频繁地发生在头颈部，男性比例更高。此外，MCC的区域转移率更高，因此可能从区域分期程序中获益更多。总体而言，MCC的预后更差。
