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. 2024 Jun 6;16(11):2158.
doi: 10.3390/cancers16112158.

Incidence and Relative Survival of Patients with Merkel Cell Carcinoma in North Rhine-Westphalia, Germany, 2008-2021

Andreas Stang  1   2   3 , Lennart Möller  3 , Ina Wellmann  3 , Kevin Claaßen  3 , Hiltraud Kajüter  3 , Selma Ugurel  4 , Jürgen C Becker  4   5   6   7
Affiliations

Incidence and Relative Survival of Patients with Merkel Cell Carcinoma in North Rhine-Westphalia, Germany, 2008-2021

Andreas Stang et al. Cancers (Basel). .

Abstract

Background: To date, only a few population-representative studies have been carried out on the rare Merkel cell carcinoma (MCC). We provide incidence and survival estimates of MCC, including the conditional relative survival.

Methods: We analyzed data from the cancer registry of North Rhine-Westphalia, Germany, 2008-2021, covering a population of 18 million. We included all newly diagnosed MCCs and calculated age-standardized (old European Standard population) incidence rates and unconditional and conditional relative survival.

Results: Our analysis included 2164 MCC patients. The age-standardized incidence of MCC was 5.2 (men) and 3.8 (women) per million person-years. The 5-year relative survival was 58.8% (men) and 70.7% (women). Survival was lower among men than women in all age-sex groups and was highest for MCC of the upper extremity in both men (68.2%) and women (79.3%). The sex difference in survival is particularly due to the better survival of women with MCC of the head and neck. In terms of survival, the first two years are particularly critical.

Conclusions: Our data validate the worse survival among men and highlights a more favorable prognosis for MCCs located on the limbs. The first two years after diagnosis of MCC are the years with the highest excess mortality.

Keywords: (MeSH) carcinoma; Germany; Merkel cell; incidence; registries; survival analysis.

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Conflict of interest statement

A.S.: L.M., I.W., H.K., and K.C. do not report any conflicts of interest. S.U. declares research support from Bristol Myers Squibb and Merck Serono; speakers and advisory board honoraria from Bristol Myers Squibb, Merck Sharp & Dohme, Merck Serono, and Novartis; and meeting and travel support from Almirall, Bristol Myers Squibb, IGEA Clinical Biophysics, Merck Sharp & Dohme, Novartis, Pierre Fabre, and Sun Pharma, outside of the submitted work. J.C.B.: Speaker’s bureau honoraria from Amgen, MerckSerono, Pfizer, Recordati, and Sanofi; paid consultant/advisory/DSMB board member for Almirall, Boehringer Ingelheim, ICON, InProTher, Pfizer, 4SC, and Sanofi/Regeneron; and research grants from Bristol Myers Squibb, Merck Serono, HTG, IQVIA, and Alcedis.

Figures

Figure 1
Figure 1
Distribution of UICC stages among 2164 patients with newly diagnosed Merkel cell carcinoma in North Rhine-Westphalia, Germany, 2008–2021, before and after multiple imputation. CC: Stage distribution according to complete case analysis; percentage distribution only among cases with UICC staging information. MI: Stage distribution after multiple imputation of missing data.
Figure 2
Figure 2
Unconditional and conditional relative survival (%) among men and women with newly diagnosed Merkel cell carcinoma in North Rhine-Westphalia, Germany, 2017–2021. Legend for Figure 1: Unconditional relative survival (period approach) starts at year zero of follow-up. Conditional relative survival starts after 1, 2, 3, and 4 years, respectively.
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