Merkel Cell Carcinoma: Our Therapeutic Algorithm

Excerpt

Merkel cell carcinoma (MCC) is a growing health problem and the second most common cause of nonmelanoma skin cancer death; nevertheless, its optimal treatment is uncertain.1‐4 Recently, studying its propensity to recur locally and regionally, Warner et al. assessed the roles of sentinel node (SN) biopsy and radiotherapy. They performed a retrospective analysis of 17 patients for a median follow-up 16 months. Of 11 patients, 3 had a positive SN biopsy and, despite adjuvant radiotherapy, 2 developed regional lymph node recurrence (RLN). Of eight patients who had a negative SN biopsy, five also had RLN recurrences. There were nine patients who received adjuvant radiotherapy (RT) to the primary site, with no in-field recurrences, and eight who received RT to their RLN field, with only two developing regional nodal recurrences—both were SN biopsy positive. They concluded that SN status may not be an accurate predictor of locoregional recurrence, and that radiotherapy, both locally and to regional nodes, provides effective infield disease control.1 …