Improved Survival in Women versus Men with Merkel Cell Carcinoma

Background Studies have observed that women have better outcomes than men in melanoma, but less is known about the influence of sex differences on outcomes for other aggressive cutaneous malignancies. Objective To investigate whether women and men have disparate outcomes in Merkel cell carcinoma (MCC). Methods Patients with nonmetastatic MCC undergoing surgery and lymph node evaluation were identified from the National Cancer Database (NCDB) and the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier analysis and Cox proportional hazards regression models were used for overall survival, and competing-risks analysis and Fine-Gray models were used for cause-specific and other-cause mortality. Results The NCDB cohort (n = 4178) included 1516 (36%) women. Women had a consistent survival advantage compared with men in propensity score–matched analysis (66.0% vs 56.8% at 5 years, P  Limitations Potential selection bias from a retrospective data set. Conclusion In MCC, women have improved survival compared with men, driven by MCC-related mortality.