PDF(Pubmed)
Abstract：
Merkel cell carcinoma (MCC) is a rare but aggressive neuroendocrine tumour of the skin with poor prognosis and rising global incidence. A recently published article in BMC Cancer, titled \"Merkel cell carcinoma: a forty-year experience at the Peter MacCallum Cancer Centre\" (Wang et al.), provides a contemporary analysis of locoregional disease outcomes in Australia which highlights the comparative effectiveness of radiotherapy for excisions with involved margins versus wide local excision. There is a persistent lack of clear, well-defined guidelines to manage MCC in Australia despite experiencing the highest rates globally. The advanced age at onset also provides inherent challenges for optimal management and often, a case-by-case approach is necessary based on patient preferences, baseline function and fitness for surgery. This paper responds to the recently published article by Wang et al. and will expand the discourse regarding management of localized MCC. Specifically, we will discuss the surgical excision approaches; alternative treatment options for MCC including radiotherapy, Mohs micrographic surgery and novel immunotherapy agents being investigated through several clinical trials.
摘要：
默克尔细胞癌（MCC）是一种罕见但侵袭性的皮肤神经内分泌肿瘤，预后不良，全球发病率上升。最近发表在BMC癌症杂志上的一篇文章，题为“默克尔细胞癌：在彼得·麦克卡勒姆癌症中心40年的经验”(Wang等人。),提供了对澳大利亚局部区域疾病结局的当代分析，该分析强调了放疗对涉及边缘的切除与广泛的局部切除的比较有效性。有一个持续的缺乏明确，尽管经历了全球最高的利率，但在澳大利亚管理MCC的明确指导方针。发病年龄高也为优化管理提供了固有的挑战，根据患者的喜好，有必要采取逐案的方法，基线功能和手术适应性。本文回应了Wang等人最近发表的文章。并将扩大有关本地化MCC管理的论述。具体来说,我们将讨论手术切除方法；MCC的替代治疗方案，包括放疗，通过多项临床试验正在研究Mohs显微外科手术和新型免疫治疗剂。
