Epidemiology and survival of Merkel cell carcinoma in New Zealand: A population‐based study between 2000 and 2015 with international comparison

Lee, Young; Chao, Phillip; Coomarasamy, Christin; Mathy, Jon A.

doi:10.1111/ajd.13023

Cited by 17 publications

(16 citation statements)

References 28 publications

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“…Merkel cell carcinoma (MCC) is a neuroendocrine carcinoma of the skin with a poor prognosis. The survival rate of MCC varies significantly; population-based studies from New Zealand, Finland, and the United States revealed 5-year disease-specific survival rates of 45%, 59%, and 73%, respectively [ 1 , 2 , 3 ]. In most MCCs (approximately 80% of MCC tumors in the northern hemisphere), the genome of Merkel cell polyomavirus (MCPyV) is integrated in the tumor cell genome [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…In most MCCs (approximately 80% of MCC tumors in the northern hemisphere), the genome of Merkel cell polyomavirus (MCPyV) is integrated in the tumor cell genome [ 4 , 5 ]. Our group and others have previously identified several clinicopathological factors that negatively influence survival in MCC, such as tumor MCPyV-negativity, lack of tumor-infiltrating lymphocytes, male sex, larger primary tumor size, presence of lymph node or systemic metastasis at diagnosis, and immunosuppression [ 1 , 2 , 3 , 4 , 6 , 7 , 8 , 9 , 10 , 11 ]. Despite the generally poor survival of MCC, there is a significant proportion of patients in our Finnish population-based cohort who are still alive over a decade after the initial diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Activation of Oncogenic and Immune-Response Pathways Is Linked to Disease-Specific Survival in Merkel Cell Carcinoma

Sundqvist

Kilpinen

Böhling

et al. 2022

Cancers

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Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine carcinoma of the skin with a poor prognosis. Improving the prognosis of MCC by means of targeted therapies requires further understanding of the mechanisms that drive tumor progression. In this study, we aimed to identify the genes, processes, and pathways that play the most crucial roles in determining MCC outcomes. Methods: We investigated transcriptomes generated by RNA sequencing of formalin-fixed paraffin-embedded tissue samples of 102 MCC patients and identified the genes that were upregulated among survivors and in patients who died from MCC. We subsequently cross-referenced these genes with online databases to investigate the functions and pathways they represent. We further investigated differential gene expression based on viral status in patients who died from MCC. Results: We found several novel genes associated with MCC-specific survival. Genes upregulated in patients who died from MCC were most notably associated with angiogenesis and the PI3K-Akt and MAPK pathways; their expression predominantly had no association with viral status in patients who died from MCC. Genes upregulated among survivors were largely associated with antigen presentation and immune response. Conclusion: This outcome-based discrepancy in gene expression suggests that these pathways and processes likely play crucial roles in determining MCC outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Activation of Oncogenic and Immune-Response Pathways Is Linked to Disease-Specific Survival in Merkel Cell Carcinoma

Sundqvist

Kilpinen

Böhling

et al. 2022

Cancers

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“…Some types of cancer in Australia are the highest in the world: melanoma,26 keratinocyte and melanocyte 29. Australia and New Zealand together have the highest rates for Merkel cell carcinoma 30 31. A number of studies have focused on geographical or socioeconomic disparities in cancer care and survival 32–38.…”

Section: Introductionmentioning

confidence: 99%

Emerging cancer incidence, mortality, hospitalisation and associated burden among Australian cancer patients, 1982 – 2014: an incidence-based approach in terms of trends, determinants and inequality

Mahumud

Dunn²,

Gow³

2019

BMJ Open

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ObjectiveCancer is a leading killer worldwide, including Australia. Cancer diagnosis leads to a substantial burden on the individual, their family and society. The main aim of this study is to understand the trends, determinants and inequalities associated with cancer incidence, hospitalisation, mortality and its burden over the period 1982 to 2014 in Australia.SettingsThe study was conducted in Australia.Study designAn incidence-based study design was used.MethodsData came from the publicly accessible Australian Institute of Health and Welfare database. This contained 2 784 148 registered cancer cases over the study period for all types of cancer. Erreygers’ concentration index was used to examine the magnitude of socioeconomic inequality with regards to cancer outcomes. Furthermore, a generalised linear model was constructed to identify the influential factors on the overall burden of cancer.ResultsThe results showed that cancer incidence (annual average percentage change, AAPC=1.33%), hospitalisation (AAPC=1.27%), cancer-related mortality (AAPC=0.76%) and burden of cancer (AAPC=0.84%) all increased significantly over the period. The same-day (AAPC=1.35%) and overnight (AAPC=1.19%) hospitalisation rates also showed an increasing trend. Further, the ratio (least-most advantaged economic resources ratio, LMR of mortality (M) and LMR of incidence (I)) was especially high for cervix (M/I=1.802), prostate (M/I=1.514), melanoma (M/I=1.325), non-Hodgkin's lymphoma (M/I=1.325) and breast (M/I=1.318), suggesting that survival inequality was most pronounced for these cancers. Socioeconomically disadvantaged people were more likely to bear an increasing cancer burden in terms of incidence, mortality and death.ConclusionsSignificant differences in the burden of cancer persist across socioeconomic strata in Australia. Policymakers should therefore introduce appropriate cancer policies to provide universal cancer care, which could reduce this burden by ensuring curable and preventive cancer care services are made available to all people.

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“…Polyoma virus negative MCCs are shown more likely to occur in sun exposed regions, and have a higher mutational burden including UV light signature mutations 22 . Poor survival rates from MCC have been demonstrated in New Zealand which is thought be linked to high UV exposure, fair skin type and lower rates of MCPyV positivity in this region 23 . Interestingly, the lower limbs were noted overall to be the second most common location for MCC development.…”

Section: Discussionmentioning

confidence: 99%

Gender and immunosuppression impact on Merkel cell carcinoma diagnosis and prognosis. A population based cohort study

Keeling

O’Leary

Deady

et al. 2021

Skin Health and Disease

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Background Merkel cell carcinoma (MCC), a rare cutaneous neuroendocrine endocrine tumour is increasing in incidence, and continues to carry a poor prognosis. Objectives The objectives of this study were to examine all Irish cases of MCC from 1 January 1994 over 2 decades, focusing on gender and organ transplantation recipients (OTRs). Cases were identified from the National Cancer Registry of Ireland. Covariates of interest included age, body site, period of diagnosis, deprivation‐status and history of non‐melanoma skin cancer (NMSC). Results In total 314 MCC cases were identified. A female predominance was noted (53.8%). Comparison between age‐standardised rates between the earliest period (1994–1996) with the latest period (2012–2014) showed an increase of 105% in total. The trend in age‐standardised incidence rates were noted to be increasing significantly (p = 0.0004). Average age at diagnosis was 77.6 years (male 75.1 years, female 79.7 years). Overall, the majority of MCC cases presented on the head and neck (n = 170, 54.1%). Differences in anatomical location of MCCs were noted between genders. Males were found to be more likely to have a history of previous NMSCs (males n = 73 [57.9%], females n = 53 [42.1%]). Thirty‐one percentage of patients died from MCC, average survival was 3.5 years in those who died of this malignancy. Ten organ transplant recipients developed MCC. OTR who developed MCC were diagnosed at a younger average age of 65.1 years. Standardized incidence ratio for MCC in OTR was 59.96. A higher proportion of OTR died from MCC (70%), with a shorter median survival of 0.14 years. In competing risks regression, gender was not significantly associated with risk of dying, females having a non‐significantly higher hazard of dying. Organ transplant recipients and patients from less deprived areas were at greater risk of dying from MCC. Conclusions This population based study provides epidemiological, clinical and outcome data for MCC over a 20‐year period.

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Epidemiology and survival of Merkel cell carcinoma in New Zealand: A population‐based study between 2000 and 2015 with international comparison

Cited by 17 publications

References 28 publications

Activation of Oncogenic and Immune-Response Pathways Is Linked to Disease-Specific Survival in Merkel Cell Carcinoma

Activation of Oncogenic and Immune-Response Pathways Is Linked to Disease-Specific Survival in Merkel Cell Carcinoma

Emerging cancer incidence, mortality, hospitalisation and associated burden among Australian cancer patients, 1982 – 2014: an incidence-based approach in terms of trends, determinants and inequality

Gender and immunosuppression impact on Merkel cell carcinoma diagnosis and prognosis. A population based cohort study

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