title: Mohs Micrographic Surgery for the Treatment of Merkel Cell Carcinoma.
abstract: BACKGROUND
  Merkel cell carcinoma (MCC) is a rare, aggressive malignant neoplasm. 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.
  
  
  OBJECTIVE
  This study aims to help elucidate management of MCC and includes one of the largest groups of patients from a single institution.
  
  
  METHODS
  This study is a retrospective chart review of 22 patients with cutaneous MCC treated with MMS at our practice over 20 years. Clinical characteristics and outcomes were examined. The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki as reflected in the approval by our institution's human research review committee.
  
  
  RESULTS
  The overall local recurrence rate was 5% (1/22). The overall rate of biopsy-proven metastasis to regional lymph nodes was 14% (3/22). No cases of distant metastases were documented.
  
  
  CONCLUSIONS
  To our knowledge, this is the largest group of patients with MCC treated with MMS from a single institution and indicates that MMS may be a useful treatment modality for this rare aggressive disease.
authors.affiliation: *Piedmont Plastic Surgery and Dermatology, Gastonia, North Carolina; †Department of Dermatology, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Laura
authors.initials: L
authors.lastname: Kline
authors.forename: Brett
authors.initials: B
authors.lastname: Coldiron
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015266:Carcinoma, Merkel Cell / Q000556:secondary / Q000601:surgery* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005121:Extremities; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D015580:Mohs Surgery; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy