BACKGROUND Merkel cell carcinoma (MCC) is a rare and potentially lethal skin cancer. MCC is known for its potential rapid growth and its propensity to metastasize. OBJECTIVE To describe the incidence, treatment, and survival of MCC in a population-based setting. METHODS All MCCs diagnosed in The Netherlands between 1993 and 2016 were selected from the Netherlands Cancer Registry. Patient and tumor characteristics, therapy, and vital status were obtained. Cox proportional hazards were computed, and relative survival analyses were performed. RESULTS Our cohort included 1977 patients with MCC. Incidence increased from 0.17 per 100,000 person-years in 1993 to 0.59 per 100,000 in 2016. The mean age at diagnosis was 75.5. Most MCCs (59.8%) were treated with surgery alone. Relative 5-year survival was low (63.0%) and did not improve. Mortality was higher among males (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.11-1.39), higher age (HR, 1.07; 95% CI, 1.06-1.07), and nodal (HR, 1.26; 95% CI, 1.08-1.48) and distant spread of disease (HR, 2.44; 95% CI, 1.99-2.99). LIMITATIONS We lacked data on cause of death, comorbidity, and pathologic margins, which may have led to misinterpretation of the data. CONCLUSION This study shows continuously increasing incidence rates of MCC in The Netherlands. Survival after a diagnosis of MCC remained low. Our results emphasize the need for implementation of new therapies.

中文翻译：

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自1993年以来默克尔细胞癌的治疗和生存：在荷兰进行的一项基于人群的队列研究。

背景技术默克尔细胞癌（MCC）是一种罕见且可能致命的皮肤癌。MCC因其潜在的快速增长和转移倾向而闻名。目的描述以人群为基础的MCC的发病率，治疗和生存情况。方法从1993年至2016年在荷兰诊断出的所有MCC均选自荷兰癌症登记处。获得了患者和肿瘤的特征，治疗方法和生命状态。计算考克斯比例风险，并进行相对生存分析。结果我们的队列包括1977例MCC患者。发病率从1993年的每100,000人年0.17增加到2016年的每100,000人年0.59。诊断的平均年龄为75.5。大多数MCC（59.8％）仅接受手术治疗。相对5年生存率较低（63.0％），并且没有改善。男性的死亡率较高（危险比[HR]为1.24； 95％置信区间[CI]为1.11-1.39），较高的年龄段（HR为1.07； 95％CI为1.06-1.07）和结节（HR为1.26； 1.5％）。 95％CI，1.08-1.48）和疾病的远距离传播（HR，2.44; 95％CI，1.99-2.99）。局限性我们缺乏有关死亡原因，合并症和病理边界的数据，这可能导致对数据的误解。结论本研究表明荷兰的MCC发病率持续上升。诊断为MCC后的存活率仍然很低。我们的结果强调了实施新疗法的必要性。局限性我们缺乏有关死亡原因，合并症和病理边界的数据，这可能导致对数据的误解。结论这项研究表明荷兰的MCC发病率持续上升。诊断为MCC后的存活率仍然很低。我们的结果强调了实施新疗法的必要性。局限性我们缺乏有关死亡原因，合并症和病理边界的数据，这可能导致对数据的误解。结论本研究表明荷兰的MCC发病率持续上升。诊断为MCC后的存活率仍然很低。我们的结果强调了实施新疗法的必要性。