title: Merkel cell carcinoma: Do you know your guidelines?
abstract: BACKGROUND
  Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine malignancy that exhibits clinically aggressive features and is associated with a poor prognosis. The incidence of MCC seems to be increasing for reasons unknown, and is estimated to be 0.32/100,000 in the United States.
  
  
  METHODS
  This article will review the current literature and National Comprehensive Cancer Network practice guidelines in the treatment of MCC.
  
  
  RESULTS
  Resection of MCC with negative margins remains the mainstay of therapy. Positive nodal disease should be treated with neck dissection and adjuvant radiotherapy. High-risk patients should undergo adjuvant radiotherapy, which improves oncologic outcomes. The role of chemotherapy is less clear and is currently reserved for advanced-stage MCC and palliative therapy.
  
  
  CONCLUSIONS
  The pathogenesis of MCC has recently been impacted with the discovery of the Merkel cell polyomavirus (MCPyV). Research to establish targeted and immunologic therapeutic options are ongoing.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, New York, New York.
authors.forename: Brett A
authors.initials: BA
authors.lastname: Miles
authors.affiliation: Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
authors.forename: David
authors.initials: D
authors.lastname: Goldenberg
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D015266:Carcinoma, Merkel Cell / Q000473:pathology* / Q000628:therapy / Q000821:virology; D017408:Guidelines as Topic; D006801:Humans; D059965:Merkel cell polyomavirus; D009367:Neoplasm Staging; D027601:Polyomavirus Infections / Q000473:pathology* / Q000628:therapy / Q000821:virology; D012878:Skin Neoplasms / Q000473:pathology* / Q000628:therapy / Q000821:virology; D014412:Tumor Virus Infections / Q000473:pathology* / Q000628:therapy / Q000821:virology
chemical_list: D000970:Antineoplastic Agents
keywords: MCPyV-negative; MCPyV-positive; Merkel cell carcinoma; Merkel cell polyomavirus (MCPyV); cutaneous malignancies