Background

The optimal surgical approach (wide local excision [WLE] vs Mohs micrographic surgery [MMS]) for treating Merkel cell carcinoma (MCC) is yet to be determined.

Objective

To compare survival outcomes in patients with early-stage MCC treated with MMS versus with WLE.

Methods

A retrospective review of all cases in the National Cancer Database (NCDB) of MCC of clinical stage I or II MCC treated with WLE or MMS was performed.

Results

A total of 1795 cases of stage I or II MCC who underwent WLE (n = 1685) or MMS (n = 110) were identified. There was no difference in residual tumor on surgical margins between the 2 treatment groups (P = .588). On multivariate analysis, there was no difference in overall survival between the treatment modalities (adjusted hazard ratio, 1.02; 95% confidence interval, 0.72-1.45; P = .897). There was no difference in overall survival between the 2 groups on propensity score–matched analysis.

Limitations

Disease-specific survival was not reported, as these data are not available in the National Cancer Database.

Conclusions

MMS appears to be as effective as WLE in treating early-stage MCC.

中文翻译：

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与国家癌症数据库中的广泛局部切除相比，莫氏显微手术治疗 I 期和 II 期默克尔细胞癌的人口统计学和结果

背景

治疗默克尔细胞癌 (MCC) 的最佳手术方法（广泛局部切除 [WLE] 与莫氏显微手术 [MMS]）尚未确定。

客观的

比较接受 MMS 与 WLE 治疗的早期 MCC 患者的生存结果。

方法

对国家癌症数据库 (NCDB) 中使用 WLE 或 MMS 治疗的临床 I 期或 II 期 MCC 的所有病例进行了回顾性审查。

结果

总共确定了 1795 例接受 WLE (n = 1685) 或 MMS (n = 110) 的 I 期或 II 期 MCC 病例。两个治疗组之间手术切缘上的残留肿瘤没有差异 ( P  = .588)。在多变量分析中，两种治疗方式之间的总生存期没有差异（调整后的风险比为 1.02；95% 置信区间为 0.72-1.45；P  = .897）。在倾向得分匹配分析中，两组之间的总生存期没有差异。

限制

未报告疾病特异性存活率，因为这些数据在国家癌症数据库中不可用。

结论

MMS 在治疗早期 MCC 方面似乎与 WLE 一样有效。