Merkel cell carcinoma of the head and neck: Potential histopathologic predictors

Abstract

Adjuvant radiotherapy cannot remediate a positive resection margin. Given these results, consideration for revision surgery should be considered for a positive deep margin. Frozen section analysis may help to define the margins in this invasive and aggressive disease.

Merkel cell carcinoma: Overall survival after open biopsy versus wide local excision

“…In patients with MCC, high recurrence rates have been reported with local, regional, and distant recurrence from 3% to 14%, 12% to 26%, and 12% to 28%, respectively. [12][13][14] Again, in our study, cohort similar locoregional (26%) and distant (22%) recurrence rates could be observed.…”

“…Similar to previous studies, the preponderant site of occurrence was the head and neck region, followed by the extremities. In patients with MCC, high recurrence rates have been reported with local, regional, and distant recurrence from 3% to 14%, 12% to 26%, and 12% to 28%, respectively . Again, in our study, cohort similar locoregional (26%) and distant (22%) recurrence rates could be observed.…”

Merkel cell carcinoma of the head and neck: poorer prognosis than non-head and neck sites

“…The excision of Merkel cell carcinoma primary tumours in the head and neck is often complex and limited by critical structures. This can lead to incomplete excision, with positive pathological margins and increased locoregional recurrence rates 18 – 20 . Several studies have shown that positive surgical margins are a common event for head and neck Merkel cell carcinoma 11 , 19 .…”

Best practices in surgical and nonsurgical management of head and neck Merkel cell carcinoma: An update

“…A retrospective review conducted at our institution found that despite the resection margins meeting or exceeding NCCN recommendations, the surgical margin was positive in 57% of the patients, and 92% of those were positive at the deep margin 46 . Many studies have shown survival is worse in the setting of residual tumor on surgical margins, with positive margins widely reported in 3.7%–57% of patients with MCC 47–49 . Conversely, Allen et al found no difference in local recurrence between patients with resection margins smaller than 1 cm (9%) and patients with resection margins 1 cm or wider (10%) ( p = 0.83) 50 .…”

“… 46 Many studies have shown survival is worse in the setting of residual tumor on surgical margins, with positive margins widely reported in 3.7%–57% of patients with MCC. 47 , 48 , 49 Conversely, Allen et al found no difference in local recurrence between patients with resection margins smaller than 1 cm (9%) and patients with resection margins 1 cm or wider (10%) ( p = 0.83). 50 However, they did find head and neck tumor location was associated with a higher 5‐year DSS by univariate analysis.…”