Second neoplasms in patients with Merkel cell carcinoma

• Published in: Cancer 2001-04, Vol.91 (7), p.1358-1362
• Main Authors: Brenner, Baruch, Sulkes, Aaron, Rakowsky, Erica, Feinmesser, Meora, Yukelson, Aviel, Bar‐Haim, Erez, Katz, Alan, Idelevich, Efraim, Neuman, Avivit, Barhana, Micha, Fenig, Eyal
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Merkel Cell - epidemiology; Carcinoma, Merkel Cell - mortality; Carcinoma, Merkel Cell - therapy; Dermatology; Female; Humans; Incidence; Israel - epidemiology; Male; Medical sciences; Merkel cell carcinoma; Middle Aged; Neoplasms, Second Primary - epidemiology; second neoplasms; Skin Neoplasms - epidemiology; Skin Neoplasms - mortality; Skin Neoplasms - therapy; specific mortality; Tumors of the skin and soft tissue. Premalignant lesions
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(20010401)91:7<1358::AID-CNCR1139>3.0.CO;2-C

BACKGROUND Merkel cell carcinoma (MCC) has been associated with a high incidence of other skin tumors and hematological malignancies. The purpose of this study was to analyze data from the Israel Cancer Registry regarding the incidence of second neoplasms in patients with MCC and their impact on survival. METHODS Sixty‐seven patients in whom MCC was diagnosed between 1983 and 1999 were included. Data were collected on age, gender and ethnic origin, dates of diagnosis of MCC and any other neoplasm, and date and cause of death, if applicable. Comparison of MCC‐specific survival, estimated by the Kaplan–Meier product limit method, between patients with no other neoplasm and those with second primary tumors was performed by log rank test. Age‐specific standardized incidence ratio (SIR) was calculated using 5751 age‐ and ethnic‐matched malignant melanoma patients as a control group. RESULTS Seventeen patients (25%) had a second neoplasm before, concomitant with, or after the diagnosis of MCC; 2 of them also had a third primary tumor. The SIR was 2.8 (95% CI; range, 1.38–4.22), significantly higher than the control group. Almost half the tumors were squamous cell carcinomas, either skin or head and neck, and most of the remainder were hematological malignancies or breast and ovarian adenocarcinomas. On univariate analysis, the presence of another neoplasm, regardless of its chronology, was associated with higher MCC‐specific mortality (65% vs. 40% for patients with MCC only; P = 0.022). Analysis of only those patients in whom a second neoplasm developed during follow‐up after treatment for MCC yielded an estimated actuarial risk of developing a second primary of 2.1% for each year of observation. CONCLUSIONS There is a high incidence of second neoplasms, including noncutaneous solid tumors, in patients with MCC. The presence of these neoplasms, whether they appear before, after, or simultaneously with MCC, is associated with a higher MCC‐specific mortality. Cancer 2001;91:1358–62. © 2001 American Cancer Society. Merkel cell carcinoma (MCC) is associated with a high incidence of second neoplasms, both cutaneous and noncutaneous, which confer a higher MCC‐specific mortality on affected patients.