Poulsen Michael
Southern Zone Radiation Oncology Services, Mater Centre, Brisbane, Queensland, Australia.
Drugs Aging. 2005;22(3):219-29. doi: 10.2165/00002512-200522030-00004.
Merkel cell carcinoma (MCC) of the skin is a rare form of cutaneous malignancy of neuroendocrine origin with a propensity to affect predominately elderly patients in sun-exposed areas. The tumour has an extremely aggressive growth pattern with the potential to seed into the dermal lymphatics at an early stage as well as spread to nodes and distant sites. Successful outcomes can be achieved with early diagnosis and a multidisciplinary approach to management. Patients with MCC should be carefully staged to exclude distant metastatic disease. Treatment should be approached with both the primary site and the lymph nodes in mind. The primary site should be excised with clear margins, followed by postoperative radiotherapy to the primary site and affected nodes. Addition of chemotherapy to patients perceived to be at high-risk of distant recurrence (e.g. those with involved nodes) has been considered, but evidence supporting this approach is relatively scant. This treatment strategy needs to be approached with caution in the elderly because of the risk of myelosuppression. An aggressive treatment approach is warranted at the first attempt to treat MCC as treatment for recurrent disease is less likely to be successful.
皮肤默克尔细胞癌（MCC）是一种罕见的神经内分泌源性皮肤恶性肿瘤，主要影响暴露于阳光下的老年患者。该肿瘤具有极其侵袭性的生长模式，早期有可能播散至真皮淋巴管，也可扩散至淋巴结和远处部位。早期诊断和多学科管理方法可取得成功的治疗结果。MCC患者应仔细分期以排除远处转移性疾病。治疗时应同时考虑原发部位和淋巴结。原发部位应切除至切缘阴性，随后对原发部位和受累淋巴结进行术后放疗。对于被认为远处复发风险高的患者（如淋巴结受累者），已考虑加用化疗，但支持这种方法的证据相对较少。由于存在骨髓抑制风险，在老年患者中采用这种治疗策略需谨慎。首次治疗MCC时应采取积极的治疗方法，因为复发性疾病的治疗不太可能成功。
