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. 2024 Aug 9;24(1):670.
doi: 10.1186/s12877-024-05222-8.

High cardiovascular mortality risk among older merkel cell carcinoma patients

Jia-Nan Huang #  1   2 , Hai Yu #  1 , Xichun Xia #  3   4 , Wai-Kit Ming  5 , Shuai Wu  1   6 , Leong Nga Cheng  1   7 , Lee ALice Yu Ying  8 , Jinrong Zhang  1 , Yuzhen Jiang  9 , Wenhui Chen  10 , Qiqi Zhao #  11   12 , Jun Lyu #  13   14 , Liehua Deng #  15   16
Affiliations

High cardiovascular mortality risk among older merkel cell carcinoma patients

Jia-Nan Huang et al. BMC Geriatr. .

Abstract

Objective: Previous research has primarily focused on the incidence and mortality rates of Merkel cell carcinoma (MCC), neglecting the examination of cardiovascular mortality (CVM) risk among survivors, particularly older patients. This study aims to assess the risk of CVM in older individuals diagnosed with MCC.

Methods: Data pertaining to older MCC patients were obtained from the Surveillance, Epidemiology, and End Results database (SEER). CVM risk was measured using standardized mortality ratio (SMR) and cumulative mortality. Multivariate Fine-Gray's competing risk model was utilized to evaluate the risk factors contributing to CVM.

Results: Among the study population of 2,899 MCC patients, 465 (16.0%) experienced CVM during the follow-up period. With the prolongation of the follow-up duration, the cumulative mortality rate for CVM reached 27.36%, indicating that cardiovascular disease (CVD) became the second most common cause of death. MCC patients exhibited a higher CVM risk compared to the general population (SMR: 1.69; 95% CI: 1.54-1.86, p < 0.05). Notably, the SMR for other diseases of arteries, arterioles, and capillaries displayed the most significant elevation (SMR: 2.69; 95% CI: 1.16-5.29, p < 0.05). Furthermore, age at diagnosis and disease stage were identified as primary risk factors for CVM, whereas undergoing chemotherapy or radiation demonstrated a protective effect.

Conclusion: This study emphasizes the significance of CVM as a competing cause of death in older individuals with MCC. MCC patients face a heightened risk of CVM compared to the general population. It is crucial to prioritize cardiovascular health starting from the time of diagnosis and implement personalized CVD monitoring and supportive interventions for MCC patients at high risk. These measures are essential for enhancing survival outcomes.

Keywords: And End results database (SEER); Cardiovascular disease (CVD); Cardiovascular mortality (CVM); Competing risk model; Cumulative mortality; Epidemiology; Merkel cell carcinoma (MCC); Risk factor; Standardized mortality ratio (SMR); Surveillance.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Study design
Fig. 2
Fig. 2
Nelson-Aalen cumulative risk curve of CVM in MCC patients
Fig. 3
Fig. 3
Nelson-Aalen cumulative risk curves for variables
See this image and copyright information in PMC

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