Merkel cell carcinoma: Do you know your guidelines?
- Head Neck. 2016 May;38(5):647-52. doi: 10.1002/hed.24359.
- 1. Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, New York, New York.
- 2. Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
Background: Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine malignancy that exhibits clinically aggressive features and is associated with a poor prognosis. The incidence of MCC seems to be increasing for reasons unknown, and is estimated to be 0.32/100,000 in the United States.
Methods: This article will review the current literature and National Comprehensive Cancer Network practice guidelines in the treatment of MCC.
Results: Resection of MCC with negative margins remains the mainstay of therapy. Positive nodal disease should be treated with neck dissection and Adjuvant radiotherapy. High-risk patients should undergo Adjuvant radiotherapy, which improves oncologic outcomes. The role of chemotherapy is less clear and is currently reserved for advanced-stage MCC and palliative therapy.
Conclusion: The pathogenesis of MCC has recently been impacted with the discovery of the Merkel cell polyomavirus (MCPyV). Research to establish targeted and immunologic therapeutic options are ongoing.