A number of factors are associated with advanced stage Merkel cell carcinoma (MCC) at initial diagnosis and the use of radiation therapy (RT), a recent study found. Therefore, healthcare models should account for these factors, and efforts should be directed toward improving those that are modifiable. Researchers conducted a cross-sectional, retrospective analysis of MCC patients registered in the National Cancer Database during 2004-2013. A total of 11,917 patients were identified. 3,152 and 4,586 patients were excluded from the staging and RT analyses, respectively, due to lack of available data. They found:

• African American ethnicity, lack of medical insurance, a Charlson/Deyo comorbidity score of at least 1, residing >26 miles from a treatment facility, tumor located on the lower limb/hip or trunk, and poorly or undifferentiated tumor histology predicted advanced stage MCC at the time of initial diagnosis.
• The use of RT was associated with Native American ethnicity, tumor size between 1.5-2.7 cm, electing not to have surgery, positive post-surgical margins, and receiving treatment at a comprehensive cancer program.