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Merkel cell carcinoma of skin-current controversies and recommendations

The review covers the current recommendations for Merkel cell carcinoma (MCC), with detailed discussion of many controversies. The 2010 AJCC staging system is more in-line with other skin malignancies although more complicated to use. The changes in staging system over time make comparison of studie...

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Autores principales: Assouline, Avi, Tai, Patricia, Joseph, Kurian, Lian, Ji Dong, Krzisch, Claude, Yu, Edward
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PAGEPress Publications 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132127/
https://www.ncbi.nlm.nih.gov/pubmed/21769322
http://dx.doi.org/10.4081/rt.2011.e23
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author Assouline, Avi
Tai, Patricia
Joseph, Kurian
Lian, Ji Dong
Krzisch, Claude
Yu, Edward
author_facet Assouline, Avi
Tai, Patricia
Joseph, Kurian
Lian, Ji Dong
Krzisch, Claude
Yu, Edward
author_sort Assouline, Avi
collection PubMed
description The review covers the current recommendations for Merkel cell carcinoma (MCC), with detailed discussion of many controversies. The 2010 AJCC staging system is more in-line with other skin malignancies although more complicated to use. The changes in staging system over time make comparison of studies difficult. A wide excision with margins of 2.5–3 cm is generally recommended. Even for primary </= 1 cm, there is a significant risk of nodal and distant metastases and hence sentinel node biopsy should be done if possible; otherwise adjuvant radiotherapy to the primary and nodal region should be given. Difficulties of setting up trials owing to the rarity of the disease and the mean age of the patient population result in infrequent reports of adjuvant or concurrent chemotherapy in the literature. The benefit, if any, is not great from published studies so far. However, there may be a subgroup of patients with high-risk features, e.g. node-positive and excellent performance status, for whom adjuvant or concurrent chemotherapy may be considered. Since local recurrence and metastases generally occur within 2 years of the initial diagnosis, patients should be followed more frequently in the first 2 years. However delayed recurrence can still occur in a small proportion of patients and long-term follow-up by a specialist is recommended provided that the general condition of the patient allows it. In summary, physician judgment in individual cases of MCC is advisable, to balance the risk of recurrence versus the complications of treatment.
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spelling pubmed-31321272011-07-18 Merkel cell carcinoma of skin-current controversies and recommendations Assouline, Avi Tai, Patricia Joseph, Kurian Lian, Ji Dong Krzisch, Claude Yu, Edward Rare Tumors Article The review covers the current recommendations for Merkel cell carcinoma (MCC), with detailed discussion of many controversies. The 2010 AJCC staging system is more in-line with other skin malignancies although more complicated to use. The changes in staging system over time make comparison of studies difficult. A wide excision with margins of 2.5–3 cm is generally recommended. Even for primary </= 1 cm, there is a significant risk of nodal and distant metastases and hence sentinel node biopsy should be done if possible; otherwise adjuvant radiotherapy to the primary and nodal region should be given. Difficulties of setting up trials owing to the rarity of the disease and the mean age of the patient population result in infrequent reports of adjuvant or concurrent chemotherapy in the literature. The benefit, if any, is not great from published studies so far. However, there may be a subgroup of patients with high-risk features, e.g. node-positive and excellent performance status, for whom adjuvant or concurrent chemotherapy may be considered. Since local recurrence and metastases generally occur within 2 years of the initial diagnosis, patients should be followed more frequently in the first 2 years. However delayed recurrence can still occur in a small proportion of patients and long-term follow-up by a specialist is recommended provided that the general condition of the patient allows it. In summary, physician judgment in individual cases of MCC is advisable, to balance the risk of recurrence versus the complications of treatment. PAGEPress Publications 2011-04-04 /pmc/articles/PMC3132127/ /pubmed/21769322 http://dx.doi.org/10.4081/rt.2011.e23 Text en ©Copyright A. Assouline et al., 2011 This work is licensed under a Creative Commons Attribution 3.0 License (by-nc 3.0). Licensee PAGEPress, Italy
spellingShingle Article
Assouline, Avi
Tai, Patricia
Joseph, Kurian
Lian, Ji Dong
Krzisch, Claude
Yu, Edward
Merkel cell carcinoma of skin-current controversies and recommendations
title Merkel cell carcinoma of skin-current controversies and recommendations
title_full Merkel cell carcinoma of skin-current controversies and recommendations
title_fullStr Merkel cell carcinoma of skin-current controversies and recommendations
title_full_unstemmed Merkel cell carcinoma of skin-current controversies and recommendations
title_short Merkel cell carcinoma of skin-current controversies and recommendations
title_sort merkel cell carcinoma of skin-current controversies and recommendations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132127/
https://www.ncbi.nlm.nih.gov/pubmed/21769322
http://dx.doi.org/10.4081/rt.2011.e23
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