Department of Dermatologic Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, Japan.
Jpn J Clin Oncol. 2023 Jul 31;53(8):673-679. doi: 10.1093/jjco/hyad059.
Merkel cell carcinoma is a highly aggressive skin cancer characterized by neuroendocrine differentiation. This review aimed to present updates on the knowledge and current trends of clinical management of Merkel cell carcinoma. Additionally, we focused on Asian reports of Merkel cell carcinoma because most skin cancers differ substantially between Caucasians and Asians, and researchers have reported differences in Merkel cell carcinoma in racial and ethnic groups. Owing to its rarity, there is limited evidence for the epidemiology, pathogenesis, diagnosis and Merkel cell carcinoma treatment. The development of a nationwide survey or cancer registry, the identification of Merkel cell polyomavirus and the use of immune checkpoint inhibitors allowed a better understanding of its characteristics and biology and have revolutionized the clinical management of patients with Merkel cell carcinoma. Its incidence has gradually increased worldwide; however, it depends on the geographic location, race and ethnicity. No randomized prospective studies have evaluated the significance of sentinel lymph node biopsy, complete lymph node dissection and adjuvant radiation therapy; however, most patients with localized Merkel cell carcinoma are treated surgically or with post-operative radiation. Patients with distant Merkel cell carcinoma are administered immune checkpoint inhibitors as the first-line therapy; however, there is no established second-line therapy for refractory Merkel cell carcinoma. Furthermore, it is necessary to validate the favorable results of clinical studies performed in Western countries in the patients in Asia.
默克尔细胞癌是一种具有神经内分泌分化特征的高度侵袭性皮肤癌。本综述旨在介绍默克尔细胞癌的知识更新和临床管理的当前趋势。此外，我们还重点关注亚洲地区的默克尔细胞癌报告，因为白种人和亚洲人的皮肤癌有很大的不同，研究人员已经报告了不同种族和民族群体中默克尔细胞癌的差异。由于其罕见性，其流行病学、发病机制、诊断和治疗的证据有限。开展全国性调查或癌症登记、识别默克尔细胞多瘤病毒以及使用免疫检查点抑制剂，使人们能够更好地了解其特征和生物学特性，并彻底改变了默克尔细胞癌患者的临床管理。其发病率在全球范围内逐渐增加；然而，它取决于地理位置、种族和民族。目前没有随机前瞻性研究评估前哨淋巴结活检、完全淋巴结清扫和辅助放疗的意义；然而，大多数局限性默克尔细胞癌患者接受手术或术后放疗治疗。远处转移的默克尔细胞癌患者接受免疫检查点抑制剂作为一线治疗；然而，对于难治性默克尔细胞癌，尚无确立的二线治疗方法。此外，有必要验证在西方国家进行的临床研究结果在亚洲患者中的有效性。
