Narrow excision margins are appropriate for Merkel cell carcinoma when combined with adjuvant radiation: Analysis of 188 cases of localized disease and proposed management algorithm

Tarabadkar, Erica S.; Fu, Teresa; Lachance, Kristina; Hippe, Daniel S.; Pulliam, Thomas H.; Thomas, Hannah; Li, Janet Y.; Lewis, Christopher W.; Doolittle‐Amieva, Coley; Byrd, David R.; Kampp, Jeremy T.; Parvathaneni, Upendra; Nghiem, Paul

doi:10.1016/j.jaad.2020.07.079

Cited by 32 publications

(33 citation statements)

References 26 publications

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“…A few recent studies did such analysis and found that adjuvant RT is indeed powerful at controlling narrow or even positive surgical margins [ 26 , 27 ]. In a study of 179 Canadian patients, among these who had a narrow excision (<1 cm), adjuvant RT was associated with a lower local recurrence rate (25 vs 5%, p = 0.03).…”

Section: Wide Local Excision Versus Narrow Excisionmentioning

confidence: 99%

“…In a separate study of 188 patients who presented without clinical nodal involvement, surgical margins of more than 1 cm were associated with a lower local recurrence rate among patients who underwent surgery alone. However, for patients who received adjuvant RT, local control was excellent (1% local recurrence) regardless of surgical margin size even for patients who had microscopically positive margins [ 27 ].…”

Section: Wide Local Excision Versus Narrow Excisionmentioning

confidence: 99%

“…However, SLNB for head and neck tumors has a higher false-negative or technically unsuccessful result due to the complex lymphatic drainage in the area [30]. Adapted with permission from [27].…”

Section: Sentinel Lymph Node Biopsymentioning

confidence: 99%

“…(F) Decision on re-excision based on clinical setting (narrow path margins, e.g., <0.5 cm) and patient preference, re-excision versus aRT versus observation. aRT: Adjuvant radiation treatment; MCC: Merkel cell carcinoma.Adapted with permission from[27].…”

mentioning

confidence: 99%

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How We Treat Merkel Cell Carcinoma: Within and Beyond Current Guidelines

et al. 2021

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Merkel cell carcinoma (MCC) is an aggressive skin cancer associated with a high risk of local recurrence and distant metastasis. Optimal care of this potentially life-threatening cancer is critical but challenging because: physicians are often unfamiliar with its management due to rarity, and MCC management remains controversial, in part because it is rapidly evolving across multiple specialties. While guidelines offer a broad overview of management, they are often not sufficient when making decisions for individual patients. Herein, we present a literature review as well as practical approaches adopted at our institutions for staging, surveillance and therapy of MCC. Each of these areas are discussed in light of how they can be appropriately customized for prevalent but challenging situations. We also provide representative examples of MCC patient scenarios and how they were managed by a multidisciplinary team to identify suitable evidence-based, individualized treatment plans.

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Section: Wide Local Excision Versus Narrow Excisionmentioning

confidence: 99%

Section: Wide Local Excision Versus Narrow Excisionmentioning

confidence: 99%

Section: Sentinel Lymph Node Biopsymentioning

confidence: 99%

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confidence: 99%

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How We Treat Merkel Cell Carcinoma: Within and Beyond Current Guidelines

et al. 2021

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“…Finally, in a recently published retrospective trial ( 48 ), 188 stage I–II MCCs were analyzed. A total of 48 patients were treated with surgery alone and, among them, 35 had narrow margins (≤1 cm) while 13 had margin > 1 cm.…”

Section: Treatment Of Primary Tumormentioning

confidence: 99%

Merkel Cell Carcinoma: An Immunotherapy Fairy-Tale?

et al. 2021

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Merkel cell carcinoma (MCC) is a rare, highly aggressive, neuroendocrine cutaneous tumor. The incidence of MCC is growing worldwide, and the disease-related mortality is about three-fold higher than melanoma. Since a few years ago, very little has been known about this disease, and chemotherapy has been the standard of care. Nowadays, new discoveries about the pathophysiology of this neoplasm and the introduction of immunotherapy allowed to completely rewrite the history of these patients. In this review, we provide a summary of the most important changes in the management of Merkel cell carcinoma, with a focus on immunotherapy and a landscape of future treatment strategies.

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