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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2017

Open Access 01-10-2017 | Head and Neck Oncology

Merkel Cell Carcinoma of the Head and Neck: Recommendations for Diagnostics and Treatment

Authors: Urs Dietmar Achim Müller-Richter, MD, DMD, Anja Gesierich, MD, Alexander Christian Kübler, MD, DMD, Stefan Hartmann, MD, DMD, Roman Camillus Brands, MD, DMD

Published in: Annals of Surgical Oncology | Issue 11/2017

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Abstract

Background

Merkel cell carcinoma (MCC) is a rare, aggressive tumor that often occurs in the head and neck region. Because of these features, the classifications and diagnostic and treatment regimens are frequently modified. Especially in the anatomically complex head and neck region, it is crucial to be aware of the current recommendations for diagnostics and treatment of MCC to ensure appropriate treatment. This overview aims to summarize the currently available literature.

Methods

The authors reviewed the relevant literature and international guidelines for MCC from 2012 to 2017 with respect to epidemiology and prognosis, diagnostic procedures and imaging, surgery, radiation, systemic treatment, and aftercare. These results were compared with existing guidelines, some of them current, and recommendations were derived.

Results

Marked developments in imaging have resulted in an increased use of functional imaging. The surgical concepts have changed regarding safety margins and the use of sentinel node biopsies. In systemic treatment, a move from conventional agents toward immuno-oncology can be observed.

Conclusions

For staging, it is important to be as exact as possible using functional imaging (e.g., positron emission tomography/computed tomography scan), especially in the head and neck area with its complex lymph drainage. This often plays an especially important role in early stages of the tumor, when the resection margin can be reduced to preserve the organ. Aftercare also should include functional imaging. In an advanced, metastatic stage, immuno-oncology (PD-1, PD-L1, CTLA-4) is superior to the previous methods of systemic treatment.
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Metadata
Title
Merkel Cell Carcinoma of the Head and Neck: Recommendations for Diagnostics and Treatment
Authors
Urs Dietmar Achim Müller-Richter, MD, DMD
Anja Gesierich, MD
Alexander Christian Kübler, MD, DMD
Stefan Hartmann, MD, DMD
Roman Camillus Brands, MD, DMD
Publication date
01-10-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 11/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-5993-1

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