title: Merkel cell carcinoma - a population-based epidemiological study in Finland with a clinical series of 181 cases.
abstract: BACKGROUND
  Merkel cell carcinoma (MCC) is a rare malignancy of the skin, and its incidence is reported to be rising. The purpose of this study was to calculate its incidence and survival ratios, and to describe the clinical characteristics of Merkel cell carcinoma patients in Finland.
  
  
  METHODS
  We calculated the incidence of MCC based on data from the Finnish Cancer Registry. In addition, patient files from hospitals and primary health care centres were reviewed for detailed data on the treatment and disease recurrence of 181 patients diagnosed with MCC in Finland during 1983-2004, and relative survival ratios were calculated for them.
  
  
  RESULTS
  The incidence (per 100,000) of MCC in Finland in 1989-2008 was 0.11 for men and 0.12 for women, adjusted for age to the world standard population. The mean age at diagnosis was 76 years (range 27-100), and 69% of the patients were women. The most common site of the primary tumour was the head and neck (53%). No extra benefit was gained from a wide surgical margin (≥ 2 cm) compared to a margin of 0.1-0.19 cm, but an intralesional excision was more often associated with local recurrence. None of the patients with Stage I-II disease who had received postoperative radiotherapy to the tumour bed had a local recurrence. The 5-year relative survival ratio amongst men was 36% (95% confidence interval 20-54%), and amongst women 69% (56 to -82%).
  
  
  CONCLUSIONS
  MCC is a rare disease in Finland, with incidence rates similar to those in the other Nordic countries. Our results support the view that complete excision with clear margins and post operative radiotherapy decrease local recurrences.
authors: Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland. heli.kukko@hus.fi
authors: Heli
authors: H
authors: Kukko
authors: Tom
authors: T
authors: Böhling
authors: Virve
authors: V
authors: Koljonen
authors: Erkki
authors: E
authors: Tukiainen
authors: Caj
authors: C
authors: Haglund
authors: Arun
authors: A
authors: Pokhrel
authors: Risto
authors: R
authors: Sankila
authors: Eero
authors: E
authors: Pukkala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015266:Carcinoma, Merkel Cell / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology; D012042:Registries; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome