Women may have better survival than men in Merkle cell carcinoma

Mortality associated with Merkle cell carcinoma may be lower among women compared with men, according to a retrospective study.

“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,” Moses Tam, MD, of the department of radiation oncology at New York University Langone Health, and colleagues wrote.

Tam and colleagues culled patients with nonmetastatic Merkle cell carcinoma (MCC) undergoing surgery and lymph node evaluation from the National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) database to determine whether women and men have different outcomes in MCC.

Outcomes included overall survival, cause-specific mortality and other-cause mortality.

Of the 4,178 patients in the NCDB cohort, 36% were women. Results of a propensity score-matched analysis indicated 5-year survival rates of 66% among women and 56.8% among men (P < . 001). Multivariable analysis of these data showed that the survival benefit for women persisted (HR = 0.68; 95% CI, 0.61-0.75; P < .001).

Further analysis of the NCDB data showed that the trend toward improved survival among women persisted across subgroups, including among patients receiving immunosuppressive medications.

Of the 1,202 patients in the SEER validation cohort, 38% were women. Women held a survival advantage in this group as well, with 5-year cumulative incidence rates of MCC-specific mortality observed at 16.4% for women and 26.7% for men (P = .002).

However, other-cause mortality was not different between women and men (16.8% vs. 17.8%), according to propensity score-matched results.

As with the NCDB results, analysis of the SEER findings showed that the trend toward a survival benefit for women endured in subgroup analysis.

The researchers noted that the findings may be limited by selection bias associated with retrospective data set.

“We found that women with MCC have a survival advantage over men that is independent of other prognostic factors and was seen in all subgroups,” they wrote. “The female survival advantage is entirely driven by MCC-related mortality and not by competing causes of mortality.”