title: Merkel cell carcinoma.
abstract: OBJECTIVE
  To determine the natural history and treatment outcomes for patients with Merkel cell carcinoma.
  
  
  METHODS
  Review of the literature.
  
  
  RESULTS
  The probability of regional node involvement at presentation exceeds 50%; few patients present with distant metastases. Comprehensive treatment of the primary site and regional lymphatics with surgery or radiotherapy results in the highest likelihood of cure. The role of adjuvant chemotherapy remains investigational.
  
  
  CONCLUSIONS
  The probability of regional dissemination at diagnosis is high. The optimal treatment is resection of the primary tumor and treatment of the regional lymphatics. Resection of all gross tumor should be accomplished followed by local-regional radiotherapy in most patients.
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL 32610-0385, USA. mendewil@shands.ufl.edu
authors.forename: William M
authors.initials: WM
authors.lastname: Mendenhall
authors.forename: Charles M
authors.initials: CM
authors.lastname: Mendenhall
authors.forename: Nancy Price
authors.initials: NP
authors.lastname: Mendenhall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015266:Carcinoma, Merkel Cell / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy