Department of Dermatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
J Am Acad Dermatol. 2019 Oct;81(4):977-983. doi: 10.1016/j.jaad.2019.01.042. Epub 2019 Jan 29.
Merkel cell carcinoma (MCC) is a rare and potentially lethal skin cancer. MCC is known for its potential rapid growth and its propensity to metastasize.
To describe the incidence, treatment, and survival of MCC in a population-based setting.
All MCCs diagnosed in The Netherlands between 1993 and 2016 were selected from the Netherlands Cancer Registry. Patient and tumor characteristics, therapy, and vital status were obtained. Cox proportional hazards were computed, and relative survival analyses were performed.
Our cohort included 1977 patients with MCC. Incidence increased from 0.17 per 100,000 person-years in 1993 to 0.59 per 100,000 in 2016. The mean age at diagnosis was 75.5. Most MCCs (59.8%) were treated with surgery alone. Relative 5-year survival was low (63.0%) and did not improve. Mortality was higher among males (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.11-1.39), higher age (HR, 1.07; 95% CI, 1.06-1.07), and nodal (HR, 1.26; 95% CI, 1.08-1.48) and distant spread of disease (HR, 2.44; 95% CI, 1.99-2.99).
We lacked data on cause of death, comorbidity, and pathologic margins, which may have led to misinterpretation of the data.
This study shows continuously increasing incidence rates of MCC in The Netherlands. Survival after a diagnosis of MCC remained low. Our results emphasize the need for implementation of new therapies.
Merkel 细胞癌（MCC）是一种罕见且具有潜在致命性的皮肤癌。MCC 的特点是可能快速生长并易于转移。
描述在基于人群的环境中 MCC 的发病率、治疗和生存情况。
从荷兰癌症登记处中选择了 1993 年至 2016 年间在荷兰诊断出的所有 MCC。获取了患者和肿瘤特征、治疗方法和生存状态。计算了 Cox 比例风险，并进行了相对生存分析。
我们的队列包括 1977 例 MCC 患者。发病率从 1993 年的每 100,000 人年 0.17 例增加到 2016 年的每 100,000 人年 0.59 例。诊断时的平均年龄为 75.5 岁。大多数 MCC（59.8%）单独采用手术治疗。相对 5 年生存率较低（63.0%），且没有改善。男性死亡率较高（风险比 [HR]，1.24；95%置信区间 [CI]，1.11-1.39），年龄较大（HR，1.07；95% CI，1.06-1.07），以及淋巴结（HR，1.26；95% CI，1.08-1.48）和远处转移（HR，2.44；95% CI，1.99-2.99）的患者死亡率较高。
我们缺乏有关死亡原因、合并症和病理切缘的数据，这可能导致对数据的误解。
本研究显示荷兰 MCC 的发病率持续上升。MCC 诊断后的生存仍然较低。我们的研究结果强调需要实施新的治疗方法。
