Benefits of combined modality treatment of Merkel cell carcinoma of the head and neck: single institution experience

Balakrishnan, V.; Berry, Sandeep; Stew, Benjamin; Sizeland, Andrew

doi:10.1017/s0022215113001862

Cited by 13 publications

(9 citation statements)

References 53 publications

(241 reference statements)

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“…Forty articles were included, yielding a total of 2,109 patients with MCC treated with either WLE or MMS. There were 31 studies describing patients treated with WLE, 7,9,14–42 3 with MMS, 10,43,44 and 6 with cases treated with either WLE or MMS. 8,11,45–48 Most of the articles were retrospective cohort studies (57.5%), followed by case series (35%).…”

Section: Resultsmentioning

confidence: 99%

Mohs Micrographic Surgery Versus Wide Local Excision in the Treatment of Merkel Cell Carcinoma: A Systematic Review

et al. 2021

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BACKGROUND Merkel cell carcinoma (MCC) is an aggressive neoplasm with high rates of recurrences. Current guidelines recommend wide local excision (WLE) with 1 to 2 cm margins. However, Mohs micrographic surgery (MMS) offers a potential advantage over WLE because of its ability of sparing healthy tissue and assessing 100% of margins. OBJECTIVE To systematically evaluate the surgical modalities for the treatment of MCC. MATERIALS AND METHODS Eligible articles were identified using MEDLINE, Scopus, EMBASE, and Cochrane Library. All available studies investigating surgical treatment of MCC with WLE or MMS were considered. RESULTS Forty studies met the inclusion criteria. Thirty-one studies described patients treated with WLE, 3 with MMS, and 6 with either WLE or MMS. Subgroup analysis of Stage I MCC showed recurrence rates similar in both surgical modalities with local recurrence rate of 6.8% for WLE versus 8.5% for MMS (p 5 .64) and a regional recurrence rate of 15.2% for WLE versus 15.3% for MMS (p 5 .99). CONCLUSION Overall WLE cases were at a higher stage at presentation. Subgroup analysis showed that MMS is not inferior to WLE excision for the treatment of Stage I MCC and is a reasonable option for anatomic locations where tissue sparing is important.This review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A primary literature search was conducted with the databases MEDLINE, Scopus, EMBASE, and Cochrane Library. We identified eligible articles from database inception to April 6, 2020. The search terms were "Merkel

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Section: Resultsmentioning

confidence: 99%

Mohs Micrographic Surgery Versus Wide Local Excision in the Treatment of Merkel Cell Carcinoma: A Systematic Review

et al. 2021

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“…Positive nodal disease should be treated with neck dissection and adjuvant radiotherapy. 89 , 95 In the event of pathologically confirmed negative nodes, patients at high risk for locoregional recurrence should have neck dissection and/or radiotherapy of nodal basins. 75…”

Section: Treatmentmentioning

confidence: 99%

Merkel cell carcinoma of the head and neck: pathogenesis, current and emerging treatment options

Saini

Miles

2015

OTT

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Merkel cell carcinoma (MCC) is a relatively uncommon, neuroendocrine, cutaneous malignancy that often exhibits clinically aggressive features and is associated with a poor prognosis. It typically presents as a painless, rapidly enlarging, dome-shaped red or purplish nodule in a sun-exposed area of the head and neck or upper extremities. Our understanding of MCC has increased dramatically over the last several years and the pathogenesis continues to be an area of active research. The etiology is likely multifactorial with immunosuppression, UV-induced skin damage, and viral factors contributing to the development of MCC. The recent discovery of Merkel cell polyomavirus has allowed for at least one aspect of disease development to be much better understood. In most cases, treatment consists of wide local excision with adjuvant radiation therapy. The role of chemotherapeutics is still being defined. The recent advancement of knowledge regarding the pathogenesis of MCC has led to an explosion research into novel therapeutic agents and strategies. This review seeks to summarize the current body of literature regarding the pathogenesis of MCC and potential targets for future therapies.

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“…28,[71][72][73][74] Positive nodal disease should be treated with neck dissection and adjuvant radiotherapy. 69,75 In the event of pathologically confirmed negative nodes, patients at high risk for locoregional recurrence should have treatment of the neck, which may include neck dissection and/or radiotherapy. 65 Radiotherapy can be considered for primary therapy in patients who are not surgical candidates.…”

Section: Treatment Guidelinesmentioning

confidence: 99%

“…Mohs micrographic surgery has been proposed as an alternative to wide local excision, and the current guidelines suggest this as an alternative if indicated by anatomic factors . Positive nodal disease should be treated with neck dissection and adjuvant radiotherapy . In the event of pathologically confirmed negative nodes, patients at high risk for locoregional recurrence should have treatment of the neck, which may include neck dissection and/or radiotherapy …”

Section: Introductionmentioning

confidence: 99%

Merkel cell carcinoma: Do you know your guidelines?

Miles

Goldenberg

2015

Head & Neck

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Benefits of combined modality treatment of Merkel cell carcinoma of the head and neck: single institution experience

Cited by 13 publications

References 53 publications

Mohs Micrographic Surgery Versus Wide Local Excision in the Treatment of Merkel Cell Carcinoma: A Systematic Review

Mohs Micrographic Surgery Versus Wide Local Excision in the Treatment of Merkel Cell Carcinoma: A Systematic Review

Merkel cell carcinoma of the head and neck: pathogenesis, current and emerging treatment options

Merkel cell carcinoma: Do you know your guidelines?

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