Skin cancer

Skin cancer patients face a 5-year recurrence rate of 40 per cent, says study 

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Merkel cell carcinoma (MCC) patients have a 40% 5-year recurrence risk, according to a recent study from the University of Washington School of Medicine. This is much greater than the melanoma and other skin cancer recurrence rates. The research’s findings were published in the journal ‘JAMA Dermatology.’

Furthermore, 95% of MCC recurrences occurred in the first three years in the research cohort of over 600 patients, indicating that monitoring efforts should be concentrated in that time frame, according the researchers.

“Merkel cell carcinoma is a life-altering diagnosis for many people. Clinic appointments, imaging studies, and blood samples may be time-consuming, pricey, and stressful. We now have information on the time intervals and cancer stages that need to be increased or decreased surveillance “Dr Aubriana McEvoy, who headed the study while at the University of Washington School of Medicine, explained why. She is a dermatology resident at Washington University School of Medicine in St. Louis.

Merkel cell cancer is a rare, aggressive kind of skin cancer that is more likely to be deadly than invasive melanoma, basal-cell, and squamous-cell carcinomas. Merkel cell carcinoma is made up of cells that resemble ‘Merkel’ cells, which are found in the epidermis, or outer layer of the skin. Merkel cells provide touch-related information to the brain, such as pressure and texture.

This research included 618 patients (37% female) ranging in age from 11 to 98, with a median age of 69. The median length of first treatment (surgery, radiation, and systemic therapy) in this sample was 90 days.

The authors wanted to know how MCC identified at pathologic (mentioned below) and clinical stages affected the probability of recurrence after therapy.

At one year, the chance of recurrence was determined to be:

Patients with stage I disease-account for 11% of the total.

Patients with stage IIA/IIB disease-account for 33% of the total.

Patients with stage IIIA disease-account for 30% of the total.

Patients with stage IIIB disease-account for 45% of the total.

Patients with stage IV disease-account for 58% of the total.

Advanced age, male sex, immunosuppression, and a known initial lesion among clinically detectable nodal illnesses were all shown to be related to a greater probability of recurrence.

Survival among cohort participants was highly influenced by the cancer stage at the time of diagnosis, as expected: Patients identified at stage I had a 95 percent MCC-specific survival rate five years after therapy, compared to 41% for patients diagnosed at stage IV.

As patients, with a median age of 70 at diagnosis, are at “considerable” risk of mortality from illnesses unrelated to cancer, MCC survival “is a more accurate estimate of disease risk than overall survival,” the investigators noted.

Again, the stage at diagnosis was linked with a significant difference: MCC was responsible for 90% of fatalities among patients with stage IV illness, but only 57 percent of deaths among patients with stage I disease.

MCC is rare in the United States compared to other skin cancers, but it is on the rise due to the disease’s tight association with ageing. According to a 2018 research by Nghiem and colleagues, about 3,200 cases will be diagnosed this year.

This year, however, around 100,000 new melanomas will be diagnosed. According to the Skin Cancer Foundation, basal cell carcinoma is significantly more frequent, with 3.6 million cases diagnosed each year, whereas squamous cell carcinoma has 1.8 million new cases each year.

Melanoma, squamous cell carcinoma, and basal cell carcinoma all had lower post-treatment recurrence rates than MCC, according to the authors: melanoma is 19%, squamous cell carcinoma is 5-9%, and basal cell carcinoma is 1-2%.