Unanswered Questions in the Management of Stage I-III Merkel Cell Carcinoma

Many unanswered questions remain about what constitutes appropriate guidelines for treatment of Merkel cell carcinoma (MCC). In this review, we address current uncertainty surrounding optimal management of Merkel cell carcinoma. These areas of uncertainty include early recognition features; clinical and histopathologic prognostic factors; optimum margins of excision of the primary tumor; indications for and value of surgical staging of the clinically negative regional nodes; optimum management of the patient with pathologically positive regional nodes; and indications for and value of radiation to the primary and regional nodes. Through identifying and elaborating on these areas of uncertainty, the authors hope to foster additional research and ultimately improve the evidence base for future iterations of the NCCN Clinical Practice Guidelines in Oncology in this rare but increasingly encountered cutaneous malignancy. The intent, however, is not to exhaustively identify all areas of controversy, but rather to highlight clinically relevant questions that further studies could address to improve the standard of care for MCC.

Target Audience

This activity has been designated to meet the educational needs of physicians and nurses involved in the management of patients with cancer.

Learning Objectives

Upon completion of this activity, participants will be able to:

  • Identify areas of uncertainty surrounding management of Merkel cell carcinoma
  • Compare management options for patients with clinically positive or negative nodes
  • Summarize available data on radiation therapy in the treatment of Merkel cell carcinoma
Additional information
Supporters: 

No commercial support was received for this article.

Course summary
Available credit: 
  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician
Course opens: 
03/10/2014
Course expires: 
03/10/2015
Cost:
$0.00

Jonathan S. Zager, MD
Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center
Department of Oncologic Sciences, University of South Florida Morsani College of Medicine
Tampa, Florida

Jane L. Messina, MD
Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center
Department of Oncologic Sciences, University of South Florida Morsani College of Medicine
Department of Anatomic Pathology, H. Lee Moffitt Cancer Center
Tampa, Florida

L. Frank Glass, MD
Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center
Tampa, Florida

Vernon K. Sondak, MD
Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center
Department of Oncologic Sciences, University of South Florida Morsani College of Medicine
Tampa, Florida

Available Credit

  • 1.00 Participation
  • 1.00 Nurse
  • 1.00 Physician

Accreditation Period

Course opens: 
03/10/2014
Course expires: 
03/10/2015

Price

Cost:
$0.00
Please login or register to take this course.

Required Hardware/software

To access this activity, users will need:

  • A device with an Internet connection
  • Adobe Reader or other PDF reader software for article and certificate viewing/printing