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Skin Cancer01:30

Skin Cancer

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Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...
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Local Recurrence Following Complete Surgical Excision of Primary Merkel Cell Carcinoma.

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Surgical excision alone for Merkel cell carcinoma (MCC) provides excellent local control with a low 1.8% recurrence rate. Adjuvant radiotherapy is not routinely recommended after negative-margin surgery for this rare skin cancer.

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Area of Science:

  • Oncology
  • Dermatology
  • Surgical Oncology

Background:

  • Merkel cell carcinoma (MCC) is a rare neuroendocrine skin cancer with a high risk of local recurrence.
  • Investigating the actual risk of local recurrence (LR) after surgical excision is crucial for treatment planning.

Purpose of the Study:

  • To determine the true risk of local recurrence (LR) in patients with Merkel cell carcinoma (MCC) treated with surgical excision alone.
  • To evaluate the efficacy of adjuvant radiotherapy (RT) in preventing or treating LR in MCC.

Main Methods:

  • A retrospective analysis of 447 patients with clinically localized MCC treated between November 1980 and December 2022.
  • Patients with pathologically negative surgical margins were included. Cumulative incidence of LR was estimated using death as a competing event.

Main Results:

  • Among 447 patients, 393 (88%) had surgery alone and 54 (12%) received adjuvant RT.
  • The 1-year LR rate was 1.8% (95% CI 0.8-3.6%) in patients treated with surgery alone.
  • LR was effectively managed with surgery and/or RT, with most patients achieving no evidence of disease.

Conclusions:

  • Negative-margin surgery alone provides excellent local control for MCC, with a low LR rate.
  • Routine adjuvant RT is not supported for all patients following complete excision of primary MCC.
  • Adjuvant RT may be considered selectively based on individual patient factors and recurrence risk.