Primary Tumor Thickness as a Prognostic Factor in Merkel Cell Carcinoma: The Next Big Thing?

Excerpt

Fifty years ago, there was a cutaneous malignancy that was rapidly increasing in incidence and beginning to receive serious scrutiny by surgical oncologists, dermatopathologists, and dermatologists. It nearly always presented at a locally advanced stage with an expectation of a poor outcome. Prognostic factors were poorly understood, so the occasional patient with advanced disease who defied expectations and survived long-term was a notable and mysterious case. Controversy surrounded the management of the regional lymph nodes, despite recognition that they were frequently the first (and sometimes the only) site of metastatic involvement—in part because of pessimism that distant dissemination of tumor had already occurred and hence treating the nodes was a futile effort. The name of this malignancy? Melanoma. …