title: Dramatic Increase in the Incidence and Mortality from Merkel Cell Carcinoma in the United States.
abstract: Merkel cell carcinoma is a cutaneous neuroendocrine neoplasm that has been poorly studied in contemporary cohorts. Patients with Merkel cell carcinoma from 1986 to 2011 were identified in the Surveillance Epidemiology and End Results registry. A total of 5211 patients met the inclusion criteria. The mean age was 74.9 years; majority were male (61.4%) and white (94.9%). Patients were divided into two cohorts: Group 1 (1986 and 1999) and Group 2 (1999-2010). Group 2 was more likely to have Stage III disease (14.6 vs 23.3%, P < 0.001) and less likely to have Stage I/II disease (71.8 vs 65.1%, P < 0.0001). The increase in Stage III was likely secondary to increased use of sentinel lymph node biopsy. Disease-specific five-year survival for Stages I/II was 78.1 per cent and Stage III was 54 per cent. Disease-specific five-year survival was unchanged between Groups 1 and 2, 69.9 versus 66.6 per cent, respectively (P = 0.44). Both incidence and mortality significantly increased over the study period with P value for both trends <0.0001. In 1986, incidence and mortality rates per 100,000 were 0.22 and 0.03, respectively, and increased to 0.79 and 0.43 in 2011, respectively. There has been a greater than 333 per cent increase in mortality from Merkel cell carcinoma.
authors.affiliation: Division of Surgical Oncology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Fitzgerald
authors.forename: Samuel
authors.initials: S
authors.lastname: Dennis
authors.forename: Swapnil D
authors.initials: SD
authors.lastname: Kachare
authors.forename: Nasreen A
authors.initials: NA
authors.lastname: Vohra
authors.forename: Jan H
authors.initials: JH
authors.lastname: Wong
authors.forename: Emmanuel E
authors.initials: EE
authors.lastname: Zervos
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015266:Carcinoma, Merkel Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D018426:SEER Program; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology