Patients with Merkel cell carcinoma (MCC) may have different sites of disease, stage at diagnosis, and survival outcomes according to their racial or ethnic group, a new study suggests.
The study showed that Hispanic patients had the best survival outcomes, and Black patients were more likely than White patients to present with advanced disease. These findings were published in JAMA Dermatology.
The study included 9557 patients with MCC from the Surveillance, Epidemiology, and End Results Program database who were followed from 2000 through 2018. The majority of the cohort was White (89.9%), followed by Hispanic (5.7%), Asian American or Pacific Islander (AAPI; 2.3%), and Black (1.5%).
White patients tended to be older than Black and Hispanic patients. The proportion of patients aged 70 years or older was 72.0% of White patients, 50.7% of Black patients, and 56.4% of Hispanic patients (P <.001 for both comparisons).
Black and Hispanic patients were less likely than White patients to present with MCC of the head and neck. The proportion of patients with head and neck MCC was 43.5% of White patients, 30.8% of Black patients (P =.002), and 33.8% of Hispanic patients (P <.001).
White patients were more likely to be men, but Black patients were more likely to be women. The proportion of male patients was 64.5% in the White group and 40.4% in the Black group (P <.001).
Black patients were more likely than White patients to have advanced MCC. The proportion with advanced disease was 40.4% of Black patients and 29.2% of White patients (P =.004).
At 5 years, there was no significant difference in MCC-specific survival rates between Black patients (63.4%), White patients (66.4%), and AAPI patients (71.6%). However, Hispanic patients had a significantly higher MCC-specific survival rate at 5 years (76.2%; P <.001).
In a multivariate analysis, Hispanic ethnicity was independently associated with improved survival (hazard ratio, 0.82; 95% CI, 0.67-0.99; P =.04).
“Further investigations are warranted into the findings that, compared with White patients, Hispanic patients with MCC had improved outcomes, and Black patients did not have worse outcomes, despite presenting with more advanced disease,” the researchers concluded.
Mohsin N, Martin MR, Reed DJ, et al. Differences in Merkel cell carcinoma presentation and outcomes among racial and ethnic groups. JAMA Dermatol. Published online March 15, 2023. doi:10.1001/jamadermatol.2023.0061