Department of Dermatology, Westmead Hospital, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Australas J Dermatol. 2022 Feb;63(1):e6-e12. doi: 10.1111/ajd.13758. Epub 2021 Dec 7.
Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine tumour. While dermally invasive MCC is known to have a five-year survival of only 30-40%, the prognosis and management of MCC in situ (MCCis) is not widely reported.
We present a systematic review to elucidate the prognosis and management of MCCis.
We performed a systematic review, searching three databases to 01 June 2021. Case reports, cohort studies, clinical trials and literature reviews were considered for inclusion.
We identified 26 cases of MCCis published in the literature with a median age of 74 years and involving 19 males and 7 females. Most cases were on the face and neck (n = 17), followed by upper limb (n = 8) and lower limb (n = 1). Sentinel lymph node biopsy was performed in three patients, and all were negative. One subject underwent adjuvant radiotherapy. No MCCis-associated deaths were reported.
This review suggests that MCCis has an excellent prognosis with minimal, if any, risk of mortality and a very low risk of dermal invasion and recurrence when treated with wide local excision alone. Sentinel lymph node biopsy is unlikely to be useful for MCCis.
默克尔细胞癌（Merkel cell carcinoma，MCC）是一种罕见的原发性皮肤神经内分泌肿瘤。已知皮肤侵袭性 MCC 的五年生存率仅为 30%-40%，而 MCC 原位（Merkel cell carcinoma in situ，MCCis）的预后和管理尚未广泛报道。
我们进行了一项系统评价，以阐明 MCCis 的预后和管理。
我们进行了一项系统评价，检索了三个数据库，截至 2021 年 6 月 1 日。纳入病例报告、队列研究、临床试验和文献综述。
我们在文献中确定了 26 例 MCCis，中位年龄为 74 岁，涉及 19 名男性和 7 名女性。大多数病例发生在面部和颈部（n=17），其次是上肢（n=8）和下肢（n=1）。3 例患者行前哨淋巴结活检，均为阴性。1 例患者接受辅助放疗。未报告与 MCCis 相关的死亡。
本综述表明，MCCis 具有极好的预后，单独行广泛局部切除时，死亡率很低，如果有死亡率的话，且皮肤侵袭和复发的风险非常低。前哨淋巴结活检对 MCCis 可能用处不大。
