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Excising 3-cm Around Merkel Cell Carcinoma Urged

Most cases surface in older whites with a skin cancer history

TUESDAY, Dec. 26 (HealthDay News) -- Three-centimeter excisions around Merkel cell carcinoma tumors lower the cancer's recurrence rate, but survival remains poor, researchers report in the December issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

Anne Dancey, of George Eliot Hospital in Nuneaton, U.K., and colleagues assessed medical records of 34 patients with primary Merkel cell carcinoma treated in two Coventry and Birmingham National Health Service trusts.

The researchers found that 97 percent of cases involved whites with a mean age of 75 years, 37 percent had a history of squamous cell carcinoma, 18 percent had basal cell carcinoma, 20 percent had actinic keratosis and 10 percent seemed immunocompromised.

Most tumors developed on extremities, attaining a mean 2.1 centimeters. Half metastasized locally. A 2-cm excision margin up to the deep fascia involved incomplete excisions in 50 percent of cases, and 33 percent local recurrence. Three-centimeter excisions including deep fascia involved a 10.5 percent recurrence. Forty percent of patients survived three years.

"We advocate a 3-cm excision margin, including fascia wherever possible, combined with post-operative radiotherapy to offer the best chance of local control," the authors write. "Survival is fairly dismal and in keeping with the aggressive nature of this tumor."

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