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Mohs micrographic surgery may be useful in treating Merkel cell carcinoma
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Mohs micrographic surgery may be a useful treatment for Merkel cell carcinoma, according to recently published study results.
“Merkel cell carcinoma (MCC) is a rare yet aggressive cutaneous malignancy,” Laura Kline, MD, of Piedmont Plastic Surgery and Dermatology, Gastonia, North Carolina, and Brett Coldiron, MD, of the department of dermatology, University of Cincinnati, wrote. “Traditionally, wide local excision has been used for local control. However, the tissue-sparing capability of Mohs micrographic surgery (MMS) and the greater certainty of complete tumor removal offer a potential advantage over wide local excision if MMS offers acceptable cure rates.”
The researchers conducted a retrospective chart review of 22 patients (12 women) who underwent excision of MCC with MMS. Mean age at time of MMS was 79.6 years, with a mean follow-up after diagnosis of 37.5 months. Sixteen tumors presented on the head and six on the extremities. Tumors had an average preoperative size of 2 cm, with an average number of 2.7 MMS stages necessary for tumor clearance.
There was an overall recurrence rate of 5% (one patient). There was a 14% rate of biopsy-proven metastasis to regional lymph nodes.
There were no reports of cases of distant metastases or death from disease.
“This is the largest cohort of patients with MCC from a single institution treated with MMS, and suggests that outcomes from MMS are at least as favorable as those from wide local excision published in other studies,” the researchers wrote.
“If MMS is at least as good as wide local excision in removing the primary tumor, and offers further advantages such as creation of a smaller initial defect, cost efficiency and decreased morbidity, the advantages unique to MMS are important arguments for using this technique for primary tumor removal,” the researchers concluded. – by Bruce Thiel
Disclosure: The researchers report no relevant financial disclosures.
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