Moses Tam1, Michael Luu2, Christopher A Barker3, Nima M Gharavi4, Omid Hamid5, Stephen L Shiao6, Anthony T Nguyen6, Diana J Lu6, Allen S Ho7, Zachary S Zumsteg8. 1. Department of Radiation Oncology, New York University Langone Health, New York, New York. 2. Department of Biostatistics and Bioinformatics, Cedars-Sinai Medical Center, Los Angeles, California. 3. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York. 4. Department of Dermatology, Cedars-Sinai Medical Center, Los Angeles, California. 5. The Angeles Clinic and Research Institute, Los Angeles, California; Department of Medical Oncology, Cedars-Sinai Medical Center, Los Angeles, California. 6. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California. 7. Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California. 8. Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California. Electronic address: zachary.zumsteg@cshs.org.
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.
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.
Authors: Monika Dudzisz-Sledz; Paweł Sobczuk; Katarzyna Kozak; Tomasz Switaj; Hanna Kosela-Paterczyk; Anna Malgorzata Czarnecka; Slawomir Falkowski; Paweł Rogala; Tadeusz Morysinski; Mateusz Jacek Spalek; Marcin Zdzienicki; Tomasz Goryn; Marcin Zietek; Bozena Cybulska-Stopa; Stanisław Klek; Grazyna Kaminska-Winciorek; Barbara Ziolkowska; Anna Szumera-Cieckiewicz; Piotr Rutkowski Journal: Cancers (Basel) Date: 2022-01-14 Impact factor: 6.639