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Annals of Oncology Advance Access published online on March 24, 2006
Annals of Oncology, doi:10.1093/annonc/mdl050
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© 2006 European Society for Medical Oncology
Received September 25, 2005
Revised February 1, 2006
Accepted February 10, 2006

review

Merkel cell cancer of the skin

D. Pectasides 1 *, M. Pectasides 1, and T. Economopoulos 1

1 Second Department of Internal Medicine, Oncology Section, University of Athens, ‘Attikon’ University Hospital, Haidari, 1 Rimini, Athens, Greece

* To whom correspondence should be addressed.
D. Pectasides, E-mail: pectasid{at}otenet.gr


  Abstract

Merkel cell carcinoma (MCC) is a rare malignant cutaneous tumor of the elderly with rapidly growing skin nodules found predominantly on sun-exposed areas of the body. The vast majority of patients present with localized disease, while up to 30% have regional lymph node metastases. Despite local excision and the incidence of local recurrence, regional lymph node metastases and distant metastases is high and usually occurs within 2 years of primary diagnosis. The optimal treatment for patients with MCC remains unclear. The best outcome is achieved with multidisciplinary management including surgical excision of primary tumor with adequate margins and post-operative radiotherapy (RT) to control local and regional disease. Patients with regional nodal metastases should be treated with lymph node dissection plus RT. Adjuvant chemotherapy (CT) should be considered as part of the initial management. In case of metastatic disease CT based on regimens used for small-cell lung cancer is the standard treatment of care.

Keywords: chemotherapy; Merkel cell carcinoma; prognosis; radiotherapy; surgery.
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