Abstract
Purpose :
Merkel Cell Carcinoma of the eyelid is a rare yet aggressive neuroendocrine tumor associated with significant morbidity and mortality. This study aimed to investigate population and survival trends related to Merkel Cell Carcinoma of the eyelid using the Surveillance, Epidemiology, and End Results (SEER) Program.
Methods :
The SEER Program national database was queried for data of patients with Merkel Cell Carcinoma of the eyelid (MCCE) from 2000-2019. Cases were analyzed by sex, race, age, geographic region, median household income, and disease stage. Survival data are reported using the Ederer II method for expected values. Statistical analysis was performed with a dedicated software package.
Results :
349 cases of MCCE were identified, accounting for 2% of all MCC cases in the US from 2000-2019. The incidence of MCCE did not change significantly over this time (p = 0.35). Female patients accounted for 56% of cases, and males for 44%. White patients accounted for 90.8% of cases, Black patients for 2.9%, 1.1% unknown and 5.2% other. Incidence of MCCE increased with age, with the majority of patients age 85+ (p<0.05). Most cases of MCCE were localized or spread to regional lymph nodes, but poorly-differentiated histologically. Notably, incidence of MCCE was greatest in metropolitan areas and in those with median income >$75,000. Income correlated with the likelihood of MCCE diagnosis (p < 0.05). Analysis of 5-year survival data showed 20% of patients died due to MCCE within 5 years of diagnosis – of these, majority died within one year of diagnosis. Higher survival was reported for female than male patients. Student’s T test showed no difference in survival with laterality. Chi-square analysis showed significant difference between observed and expected survival rates (p<0.05) for male and female patients, as well as patients age 85+, white patients, patients in metropolitan areas, and with median incomes >$50,000.
Conclusions :
The incidence of MCCE has been stable from 2000-2019. Consistent with previous reports, most patients are white, female, and age 85+. Incidence correlates with metropolitan environments and median income. While most patients do not die from MCCE, the majority of recorded deaths occur within one year of diagnosis. The information garnered in this population-based investigation may inform decisions regarding screening, the utility of biopsy of suspicious lesions, and patient counseling.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.