Abstract
ABSTRACT
Background
H&N Merkel cell carcinoma (MCC) mainly affects elderly patients, yet age‐stratified treatment patterns and outcomes data are scarce.
Methods
We analyzed 88 consecutive H&N MCC patients (2000–2022) by age (
Results
Of 88 patients, 57% were ≥ 75 years; older patients underwent less surgery but received RT at similar rates. Age ≥ 75 dominated OS (5‐year 23% vs. 71%; adjusted HR 3.24). The 5‐year cumulative incidence of MCC‐specific death was higher in older patients (42% vs. 23%) but was not independent after adjustment (cause‐specific HR 2.02,
p
= 0.10); competing non‐MCC mortality was far higher (31% vs. 6%). Six of 11 ICI‐treated patients (55%) were alive at 1.9 years.
Conclusions
Elderly patients undergo less surgery yet receive equivalent RT. Age dominates overall survival, but this mainly reflects competing non‐MCC mortality rather than a cancer‐specific effect; age‐tailored, competing‐risk‐aware protocols are needed.