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Competing risks analysis of Merkel cell carcinoma with concurrent chronic lymphocytic leukemia and non-Hodgkin lymphoma.
- Source :
-
Dermatology online journal [Dermatol Online J] 2021 Aug 15; Vol. 27 (8). Date of Electronic Publication: 2021 Aug 15. - Publication Year :
- 2021
-
Abstract
- Background: Although hematogenous malignancy is a risk factor for poorer prognosis in Merkel cell carcinoma (MCC), current guidelines make no specific recommendations for surveillance.<br />Objective: We aim to characterize MCC-specific mortality compared to other causes of death for patients with hematologic malignancy in MCC, which will guide workup and surveillance strategies.<br />Methods: The Surveillance, Epidemiology, and End Results-18 registry was queried for MCC patients with chronic lymphocytic leukemia (CLL) or non-Hodgkin lymphoma (NHL).<br />Results: Of 8519 patients with MCC, 146 (1.7%) had CLL and 234 (2.8%) had NHL. Chronic lymphocytic leukemia patients had 5-year cumulative incidence of MCC-specific mortality of 38.4% versus 28.4% in patients without CLL/NHL. For both cohorts, oncologic risk was highest within the first three years of diagnosis with competing risks favored thereafter. On competing risk regression, a history of CLL trended toward statistical significance with poorer MCC-specific mortality (subdistribution hazard ratio: 1.33, 95% CI: 0.963-1.834, P=0.084), while NHL was not prognostic.<br />Conclusions: Merkel cell carcinoma patients with CLL may benefit from more aggressive initial management. Surveillance for similar length in CLL patients with MCC may be appropriate; this co-morbidity did not affect the timeframe by which the risk of competing causes of death exceeded oncologic risks.
Details
- Language :
- English
- ISSN :
- 1087-2108
- Volume :
- 27
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Dermatology online journal
- Publication Type :
- Academic Journal
- Accession number :
- 34755954
- Full Text :
- https://doi.org/10.5070/D327854684