High cardiovascular mortality risk among older Merkel cell carcinoma patients

Merkelcell.org Summary

Cancer patients are more likely to have heart problems (cardiovascular disease or CVD) because of several factors. Cancer and heart disease share common risks, like being older or overweight. Cancer treatments can be hard on the heart, and cancer itself can make people less active and cause body changes that increase the chance of heart disease. While multiple studies show increased CVD risk in other cancers, previous research hasn’t really studied the risk of heart-related deaths in Merkel cell carcinoma (MCC) survivors, especially older patients. This study aimed to find out if MCC patients, particularly over the age of 65, have a higher chance of dying from heart problems. Using data from a large database (SEER) of nearly 3,000 MCC patients, the study found that heart disease was the second most common cause of death in older MCC patients, and that they had a higher risk of dying from heart problems than the general population. These results highlight how important it is for MCC patients, especially older ones, to prioritize and closely monitor their cardiovascular health to improve their chances of living longer.

Abstract

Objective
Previous research has primarily focused on the incidence and mortality rates of Merkel cell carcinoma (MCC), neglecting the examination of cardiovascular mortality (CVM) risk among survivors, particularly older patients. This study aims to assess the risk of CVM in older individuals diagnosed with MCC.

Methods
Data pertaining to older MCC patients were obtained from the Surveillance, Epidemiology, and End Results database (SEER). CVM risk was measured using standardized mortality ratio (SMR) and cumulative mortality. Multivariate Fine-Gray’s competing risk model was utilized to evaluate the risk factors contributing to CVM.

Results
Among the study population of 2,899 MCC patients, 465 (16.0%) experienced CVM during the follow-up period. With the prolongation of the follow-up duration, the cumulative mortality rate for CVM reached 27.36%, indicating that cardiovascular disease (CVD) became the second most common cause of death. MCC patients exhibited a higher CVM risk compared to the general population (SMR: 1.69; 95% CI: 1.54–1.86, p < 0.05). Notably, the SMR for other diseases of arteries, arterioles, and capillaries displayed the most significant elevation (SMR: 2.69; 95% CI: 1.16–5.29, p < 0.05). Furthermore, age at diagnosis and disease stage were identified as primary risk factors for CVM, whereas undergoing chemotherapy or radiation demonstrated a protective effect. Conclusion This study emphasizes the significance of CVM as a competing cause of death in older individuals with MCC. MCC patients face a heightened risk of CVM compared to the general population. It is crucial to prioritize cardiovascular health starting from the time of diagnosis and implement personalized CVD monitoring and supportive interventions for MCC patients at high risk. These measures are essential for enhancing survival outcomes.