Conditional survival estimates for merkel cell carcinoma reveal the dynamic nature of prognostication. Issue 2 (22nd March 2022)

• Record Type: Journal Article
• Authors: Miura, John T.; Lindner, Hannah; Karakousis, Giorgos C.; Sharon, Cimarron E.; Gimotty, Phyllis A.
• Is Part Of: Journal of surgical oncology. Volume 126:Issue 2(2022)
• Page Start: 348
• Page End: 355
• Publication Date: 2022-03-22
• Subjects: merkel cell carcinoma -- SEER program -- survivorship; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.26861
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract: Background and Objectives: Conditional survival (CS) analysis has emerged as a dynamic prognostication methodology. The goal of this study was to determine disease‐specific CS rates in Merkel cell carcinoma (MCC). Methods: This retrospective study included patients with MCC from the Surveillance Epidemiology and End Results (SEER) registry (1988–2016). Stage‐specific 5‐year MCC‐specific CS rates for study and survivor cohorts were estimated, and the significance of clinicopathologic factors to predict 1‐year MCC‐specific death was evaluated using multivariate logistic regression. Results: Within stage, 5‐year CS survival rates improved with increasing survivorship. Pathologic Stage I patients had the highest 5‐year CS rate at diagnosis (89.1%) but the smallest increase over time (96% among 5‐year survivors). Stage IV patients experienced the greatest change in 5‐year CS rates from 25.4% (at diagnosis) to 88% (5‐year survivors). At diagnosis stage, age, sex, and primary site were all significantly associated with 1‐year MCC‐related death in the multivariate analysis. In contrast, among 5‐year survivors only sex and age at diagnosis were significant predictors. Conclusions: MCC CS rates improved across all disease stages over time. Additionally, the relationships of prognostic factors with 1‐year MCC‐death changed with increasing survivorship. This perspective can provide a foundation for informed decision‐making.