Background/Objectives: Merkel cell carcinomais an aggressive neuroendocrine skin cancer. Australian studies report high incidence and poor survival rates compared internationally. While New Zealand has a comparable UV index and racial composition to Australia, survival outcomes are currently unknown. The role of Merkel cell polyoma virus in oncogenesis of Merkel cell carcinoma is an active area of research. We describe the incidence and survival of Merkel cell carcinoma in New Zealand with correlation to demographic and clinical factors including regional polyoma virus prevalence.Methods: Retrospective study of population-based data from the New Zealand Cancer Registry. Incidence rates were directly standardised to the US standard 2000 population. Survival was investigated using Kaplan-Meier and multivariable Cox regression models.Results: Six hundred and one cases were diagnosed in New Zealand between 2000 and 2015. The overall incidence rate was 0.96/100 000 population. Merkel cell carcinoma is more common in males, elderly and on sun-exposed areas. Eighteen percent of patients were diagnosed with distant metastasis at time of presentation. The overall 5-year survival rate and relative 5-year survival rate were 31% and 45%, respectively. Mortality was 1.9 and 2.5 times higher for stage III and IV disease, respectively, relative to stage I/II disease. Patients over age 80 had twice the mortality compared to those aged 60-69. Conclusions: New Zealand has a high incidence ofMerkel cell carcinoma and poor survival outcomes when compared internationally. We have the highest proportion of distant metastatic disease at time of diagnosis. Further research into the role of nonpolyoma-related Merkel cell carcinoma is warranted to improve Merkel cell carcinoma outcomes in New Zealand and abroad.

Background ‘Skin Shop’ is a model of care at a high‐volume tertiary centre that describes a registrar‐lead skin cancer service under consultant supervision. Ninety‐two percent of lesions are completely excised, 4.2% are narrowly excised and 3.2% are incompletely excised. Current international guidelines suggest re‐excision of incompletely excised non‐melanomatous skin cancer (NMSC); however, there is a lack of robust evidence to suggest how these lesions should be optimally managed. We describe how narrow and incompletely excised NMSC are managed in the ‘Skin Shop’ and present rates of recurrence. Methods Retrospective analysis of all lesions excised between December 2014 and June 2019. Lesion type, histological margin, presence of high‐risk features, management, presence of residual tumour in re‐excision and follow‐up duration were recorded. Rates of clinical recurrence were documented. Results From 5821 lesions excised, a total of 394 NMSC (245 basal cell carcinoma (BCC), 128 squamous cell carcinoma (SCC) and 21 Basosquamous cell carcinoma) were narrowly or incompletely excised. A total of 135 (34.3%) lesions were observed in clinic for recurrence, 133 (33.8%) lesions underwent re‐excision, 81 (20.6%) lesions underwent GP surveillance and 14 (3.6%) lesions received radiotherapy. Mean specialist clinic follow‐up was 12.4 months. Fourteen lesions recurred (3.5%, 10 BCC, 3 SCC, 1 basosquamous) of which 12 underwent re‐excision. The risk of recurrence for narrow and incompletely excised BCC was 2.9% and 10%, respectively. The corresponding rates for SCC were 2.2% and 3.3%, respectively. Conclusion Skin Shop is an effective model with low rates of narrow and incompletely excised NMSC. Risk of recurrence of these lesions is low with our current practice.

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