Incidence and outcomes of Merkel cell carcinoma related to Merkel cell polyomavirus status in Iceland in 1981-2023Capsule Summary

Maria Vygovska, MD; David Hoyt, BS; Ashley M. Snyder, PhD, MPH; Thorarinn Jonmundsson, MSc; Ashley Khouri, BS; Dev Ram Sahni, MD, MHA; Jonathan Ungar, MD; Jesse M. Lewin, MD; Nicholas Gulati, MD, PhD; Robert G. Phelps, MD; Vikram N. Sahni, MD; Jane M. Grant-Kels, MD; Helgi Sigurdsson, MD; Jon Gunnlaugur Jonasson, MD; Jonas A. Adalsteinsson, MD, PhD

JAAD International (Dec 2024)

Incidence and outcomes of Merkel cell carcinoma related to Merkel cell polyomavirus status in Iceland in 1981-2023Capsule Summary

Maria Vygovska, MD,
David Hoyt, BS,
Ashley M. Snyder, PhD, MPH,
Thorarinn Jonmundsson, MSc,
Ashley Khouri, BS,
Dev Ram Sahni, MD, MHA,
Jonathan Ungar, MD,
Jesse M. Lewin, MD,
Nicholas Gulati, MD, PhD,
Robert G. Phelps, MD,
Vikram N. Sahni, MD,
Jane M. Grant-Kels, MD,
Helgi Sigurdsson, MD,
Jon Gunnlaugur Jonasson, MD,
Jonas A. Adalsteinsson, MD, PhD

Affiliations

Maria Vygovska, MD: Division of Pathology, Landspitali-University Hospital, Reykjavik, Iceland
David Hoyt, BS: Division of Dermatology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah
Ashley M. Snyder, PhD, MPH: Department of Dermatology, University of Utah, Salt Lake City, Utah; Department of Population Health Sciences, University of Utah, Salt Lake City, Utah; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
Thorarinn Jonmundsson, MSc: Faculty of Medicine, Division of Oncology, University of Iceland, Reykjavik, Iceland
Ashley Khouri, BS: Division of Dermatology, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah
Dev Ram Sahni, MD, MHA: Department of Dermatology, Brigham and Women’s Hospital, Boston, Massachusetts
Jonathan Ungar, MD: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
Jesse M. Lewin, MD: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
Nicholas Gulati, MD, PhD: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York
Robert G. Phelps, MD: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Dermatopathology, Icahn School of Medicine at Mount Sinai, New York, New York
Vikram N. Sahni, MD: Department of Dermatology, University of Utah, Salt Lake City, Utah
Jane M. Grant-Kels, MD: Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida
Helgi Sigurdsson, MD: Faculty of Medicine, Division of Oncology, University of Iceland, Reykjavik, Iceland
Jon Gunnlaugur Jonasson, MD: Division of Pathology, Landspitali-University Hospital, Reykjavik, Iceland; Faculty of Medicine, Division of Oncology, University of Iceland, Reykjavik, Iceland
Jonas A. Adalsteinsson, MD, PhD: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York; Correspondence to: Jonas A. Adalsteinsson, MD, PhD, Department of Dermatology, Icahn School of Medicine at Mount Sinai, 5E 98th St, New York, NY 10029.

Journal volume & issue: Vol. 17
pp. 192 – 199

Abstract

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Background: Impact of Merkel cell polyomavirus (MCPyV) associated Merkel cell carcinoma (MCC) has not been assessed in the Icelandic population, nor in a whole population elsewhere. Objectives: The primary objective was to assess trends in the incidence of MCC in Iceland and the association with MCPyV. Secondary objectives aimed to analyze MCC outcomes. Methods: In this retrospective cohort study, patients diagnosed with MCC between 1981 and 2021 were identified from the Icelandic Cancer Registry. Patients were separated into 2 groups based on MCPyV immunochemistry staining. Age-standardized incidence was calculated and Joinpoint analysis was used to assess incidence trends. A Cox proportional hazards model was used to assess survival differences between the 2 groups. Results: Overall incidence of MCC increased from 0.015 to 0.26 per 100,000 persons, though the incidence of MCPyV positive cases recently decreased while negative cases increased. MCPyV negative tumors were associated with sun exposure (P < .01), a history of keratinocyte carcinoma, smaller tumor size, and lower overall survival. Limitations: Even with population-level data, comprehensively investigating associations with MCC is difficult due to its rarity. Conclusion: MCPyV negative MCC tumors were associated with lower survival despite smaller tumor size. Thus, MCPyV status could be an important prognostic biomarker.

Published in JAAD International

ISSN: 2666-3287 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Dermatology
Website: https://www.journals.elsevier.com/jaad-international

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