TY - JOUR
T1 - Merkel Cell Carcinoma, the Impact of Clinical Excision Margins and Mohs Micrographic Surgery on Recurrence and Survival
T2 - A Systematic Review
AU - Uitentuis, Sanne E.
AU - Bambach, Caroline
AU - Elshot, Yannick S.
AU - Limpens, Jacqueline
AU - van Akkooi, Alexander C. J.
AU - Bekkenk, Marcel W.
N1 - Funding Information: Alexander C.J. van Akkooi has been reimbursed for Advisory boards/consultancy by Amgen, Bristol-Myers Squibb, Novartis, MSD-Merck, Merck-Pfizer, Pierre Fabre, Sanofi, Sirius Medical, 4SC and has received research grants from Amgen and Merck-Pfizer. Yannick S. Elshot has received service fees by Nordic Pharma, Abbvie and Bristol-Myers Squibb. None are related to the current paper. The remaining authors have indicated no significant interest with commercial supporters. Publisher Copyright: © 2022 by the American Society for Dermatologic Surgery, Inc.
PY - 2022/4/1
Y1 - 2022/4/1
N2 - BACKGROUND: When treating Merkel cell carcinoma (MCC), the relation between wide local excision (WLE) margin and recurrence or survival is unclear. Mohs micrographic surgery (MMS) is an alternative surgical option for MCC, but it is unknown whether the local recurrence rate differs between MMS and WLE. OBJECTIVE: To systematically assess the available literature to determine the recurrence and survival rates when treating MCC with MMS and different clinical excision margins. MATERIALS AND METHODS: The MEDLINE, EMBASE, and CENTRAL databases were searched. Two independent reviewers selected studies that defined clear excision margins and either recurrence or survival. When possible, individual cases were extracted from case series and included in the analyses. Other studies were reviewed narratively. RESULTS: Overall, 1108 studies were identified; of which, 19 case series (168 cases) and 12 cohort studies were eligible. None of the cohort studies showed significant differences in recurrence or survival for either excision margins or MMS. Equally, logistic and Cox regression analyses of the case series revealed no significant differences in recurrence or survival between different excision margins and MMS. CONCLUSION: Synthesis of the available data does not indicate differences in recurrence and/or survival rates for MCC between different clinical excision margins and MMS.
AB - BACKGROUND: When treating Merkel cell carcinoma (MCC), the relation between wide local excision (WLE) margin and recurrence or survival is unclear. Mohs micrographic surgery (MMS) is an alternative surgical option for MCC, but it is unknown whether the local recurrence rate differs between MMS and WLE. OBJECTIVE: To systematically assess the available literature to determine the recurrence and survival rates when treating MCC with MMS and different clinical excision margins. MATERIALS AND METHODS: The MEDLINE, EMBASE, and CENTRAL databases were searched. Two independent reviewers selected studies that defined clear excision margins and either recurrence or survival. When possible, individual cases were extracted from case series and included in the analyses. Other studies were reviewed narratively. RESULTS: Overall, 1108 studies were identified; of which, 19 case series (168 cases) and 12 cohort studies were eligible. None of the cohort studies showed significant differences in recurrence or survival for either excision margins or MMS. Equally, logistic and Cox regression analyses of the case series revealed no significant differences in recurrence or survival between different excision margins and MMS. CONCLUSION: Synthesis of the available data does not indicate differences in recurrence and/or survival rates for MCC between different clinical excision margins and MMS.
UR - http://www.scopus.com/inward/record.url?scp=85128245876&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/DSS.0000000000003402
DO - https://doi.org/10.1097/DSS.0000000000003402
M3 - Review article
C2 - 35165221
SN - 1076-0512
VL - 48
SP - 387
EP - 394
JO - Dermatologic Surgery
JF - Dermatologic Surgery
IS - 4
ER -