Demographics and outcomes of stage I and II Merkel cell carcinoma treated with Mohs micrographic surgery compared with wide local excision in the National Cancer Database

Mohs surgery for early‐stage Merkel cell carcinoma (MCC) achieves local control better than wide local excision ± radiation therapy with no increase in MCC‐specific death

“…While a direct statistical comparison to historical controls treated with WLE ± RT cannot be made with this study design (i.e., retrospective review without a formal control group), Mohs surgery without RT may offer a survival that is at least as good as WLE ± RT, 3,4 with the potentially added benefits of no need for adjuvant radiation treatment or the need for further surgery for treatment of local recurrence. Notably, a recent large‐scale retrospective review of data from the National Cancer Database showed no significant difference in overall survival between MMS and WLE 6 . We hope these data fuel additional studies with larger cohorts to continue to explore the value of MMS for MCC.…”

Mohs micrographic surgery: a treatment method for many non-melanocytic skin cancers

“…Although excision is standard of care for the management of Merkel cell carcinoma, a recent review of all stage I and II Merkel cell carcinoma cases in the National Cancer Database found that MMS was equally as effective as wide local excision. This data suggests MMS as a viable option for Merkel cell carcinoma in functionally sensitive areas without sacrificing survival rates [5].…”

“…Merkel cell carcinoma is another rare but fastgrowing malignancy of neuroendocrine origin that often appears on the head and neck. Risk factors for Merkel cell carcinoma include sunlight exposure, immunosuppression, and exposure to polyomaviruses [5]. Although excision is standard of care for the management of Merkel cell carcinoma, a recent review of all stage I and II Merkel cell carcinoma cases in the National Cancer Database found that MMS was equally as effective as wide local excision.…”

A retrospective cohort study of comprehensive peripheral and deep margin assessment in Merkel cell carcinoma: Standard margins may be unreliable

“…[1][2][3] An 8% local recurrence rate after excision with negative margins vs an 18% local recurrence rate with positive margins has been reported, and survival is worse in the setting of positive margins. 3,4 In our study, despite resection margins that met or exceeded NCCN recommendations, the surgical margin was positive in 57% of the patients, and 92% of those were positive at the deep margin. Past studies have evaluated various peripheral margin widths, but the deep margin is less frequently studied.…”

“…1,2 However, many commercial panels used in clinical settings have limited validation compared to other methodologies. 3 To understand the accuracy of commercial myositis panels in the clinical setting, we performed a cross-sectional analysis of patients with DM, comparing commercially available myositis panels to panels performed in the research setting.…”