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Desai AD, Pulumati AL, Ragi SD, Eckembrecher DG, Eckembrecher FJ, Nouri K. Demographic disparities and survival rates in cutaneous appendageal carcinomas. Arch Dermatol Res 2024; 316:200. [PMID: 38775834 DOI: 10.1007/s00403-024-02995-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/12/2024] [Accepted: 04/26/2024] [Indexed: 06/05/2024]
Affiliation(s)
- Amar D Desai
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Anika L Pulumati
- University of Missouri-Kansas City School of Medicine, 2411 Holmes St, Kansas City, MO, 64108, USA.
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Sara D Ragi
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Daphne G Eckembrecher
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Francelia J Eckembrecher
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Keyvan Nouri
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Xiong DD, Mahlberg SJ, Bordeaux JS. Factors and outcomes associated with treatment delays in rare cutaneous adnexal tumors: A population-based retrospective cohort study. J Am Acad Dermatol 2024; 90:144-147. [PMID: 37666422 DOI: 10.1016/j.jaad.2023.08.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/02/2023] [Accepted: 08/27/2023] [Indexed: 09/06/2023]
Affiliation(s)
- David D Xiong
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
| | - Scott J Mahlberg
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jeremy S Bordeaux
- Department of Dermatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Lin SK, Deitermann AM, Haynes D, Ricciardelli K, Etzkorn JR, Miller CJ, Higgins HW, Giordano CN, McMurray SL, Walker JL, Zhang J, Nguyen HP, Sobanko JF. Impact of time to surgical treatment in Merkel cell carcinoma: Surveillance, Epidemiology, and End Results-based population study. J Am Acad Dermatol 2024; 90:208-210. [PMID: 37775051 DOI: 10.1016/j.jaad.2023.09.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/28/2023] [Accepted: 09/16/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Stephanie K Lin
- Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | | | - Dylan Haynes
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kaley Ricciardelli
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jeremy R Etzkorn
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Christopher J Miller
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - H William Higgins
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Cerrene N Giordano
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Stacy L McMurray
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joanna L Walker
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Junqian Zhang
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Harrison P Nguyen
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph F Sobanko
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
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Ma KL, Sharon CE, Tortorello GN, Keele L, Lukens JN, Karakousis GC, Miura JT. Delayed time to radiation and overall survival in Merkel cell carcinoma. J Surg Oncol 2023; 128:1385-1393. [PMID: 37622232 PMCID: PMC11338135 DOI: 10.1002/jso.27421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/11/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Clinically localized Merkel cell carcinoma (MCC) is commonly treated with surgical excision and radiotherapy. The relationship between time to adjuvant radiotherapy and overall survival (OS) remains understudied. METHODS This retrospective study used data from the National Cancer Database (2006-2019). Patients with clinically localized MCC who received surgical excision and adjuvant radiotherapy were included. Multivariate regressions were used to account for various patient and tumor factors. The primary outcome was 5-year OS, and the secondary outcome was time from diagnosis to adjuvant radiation (TTR). RESULTS Of the 1965 patients included, most were male (n = 1242, 63.2%) and white (n = 1915, 97.5%), and the median age was 74 years (interquartile range [IQR]: 66-81). The median TTR was 83 days (IQR: 65-106). A total of 83.6% of patients received radiotherapy to the primary site, 21.3% to the draining nodal basin, 17.1% to both, and 12.2% whose target location of radiotherapy was not recorded in the data. TTR of ≥79 days (the 45th percentile) was associated with worse OS on both univariate and multivariate analyses (log-rank p = 0.0014; hazard ratio [HR]: 1.258, 95% confidence interval [CI]: 1.055-1.500, p = 0.010). This persisted on sub-analyses of patients <80 years old (n = 1407; HR: 1.380, 95% CI: 1.080-1.764, p = 0.010) and of patients with Charlson comorbidity index (CCI) of 0 (n = 1411; HR: 1.284, 95% CI: 1.034-1.595, p = 0.024). Factors associated with delayed TTR included greater age (p = 0.039), male sex (p = 0.04), CCI > 1 (p = 0.036), academic facility (p < 0.001), rural county (p = 0.034), AJCC T2 stage (p = 0.010), negative margins (p = 0.017), 2+ pathologically positive regional nodes (p = 0.011), and margin size >2 cm (p = 0.015). CONCLUSIONS Delayed radiotherapy (≥79 days) was associated with worse OS of MCC patients. Further study in controlled cohorts is needed to ascertain this relationship.
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Affiliation(s)
- Kevin L. Ma
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Cimarron E. Sharon
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gabriella N. Tortorello
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Luke Keele
- Department of Epidemiology and Biostatistics, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John N. Lukens
- Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Giorgos C. Karakousis
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John T. Miura
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Desai AD, Behbahani S, Soliman Y, Samie FH. Factors associated with Mohs micrographic surgery in dermatofibrosarcoma protuberans of the head and neck: A cohort study. Indian J Dermatol Venereol Leprol 2023; 0:1-3. [PMID: 37436022 DOI: 10.25259/ijdvl_991_2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/12/2023] [Indexed: 07/13/2023]
Affiliation(s)
- Amar D Desai
- Department of Dermatology, Rutgers New Jersey Medical School, Newark, NJ
| | - Sara Behbahani
- Department of Dermatology, Brigham and Women's Hospital, Boston, MA
| | - Yssra Soliman
- Department of Dermatology, Columbia University Irving Medical Center, NY
| | - Faramarz H Samie
- Department of Dermatology, Columbia University Irving Medical Center, NY
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Martin MR, Mohsin N, Vilasi S, Reed D, Brownell I. Challenges documenting racial disparities in Merkel cell carcinoma. Cancer Biol Ther 2022; 23:1-3. [PMID: 36404405 PMCID: PMC9683062 DOI: 10.1080/15384047.2022.2145842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine skin cancer that predominantly impacts White patients. Overall incidence and the proportion of minority patients with MCC are both rising. In the more common skin cancer, melanoma, racial disparities are well-documented in stage at presentation and patient survival. Whether racial and ethnic disparities exist in MCC remains unclear. The study of MCC disparities is hampered by limitations in data registries, including SEER and NCDB, and an evolving natural history due to the advent of immunotherapy. Published MCC immunotherapy clinical trials consistently reported the racial diversity among enrolled subjects but failed to include patients' ethnicities. Efforts to improve data capture in cancer registries and create multi-institutional clinical databases will allow for more effective study of racial and ethnic disparities in rare cancers like MCC. Such studies are needed to advance policies promoting equity in care.
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Affiliation(s)
- Mackenzie R. Martin
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD, USA
| | - Noreen Mohsin
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD, USA
| | - Serena Vilasi
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD, USA
| | - Danielle Reed
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD, USA
| | - Isaac Brownell
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD, USA,CONTACT Isaac Brownell Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, 10 Center Drive, 12S239, Bethesda, MD20892, USA
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