Melanoma pp 623-636 | Cite as

Management of Non-melanoma Skin Cancers: Merkel Cell Carcinoma

  • Isabel PrietoEmail author
  • Teresa Pérez-de-la-Fuente
  • M Susana Medina
  • Beatriz Castelo
  • Fernando Cassinello
  • David Esteban
  • Nuria Rodriguez-Salas


Merkel cell carcinoma is a rare primary cutaneous carcinoma of the skin, which shows high aggressiveness, high risk of locoregional and distant spread, a mortality rate considerably higher than that of cutaneous melanoma, and a poor survival. Its incidence has increased during the past 20 years. The studies published from 2008 have introduced interesting changes in the understanding of its epidemiology, pathogenesis and consequently in the diagnostic codes and the therapeutic options. These advancements in our understanding of Merkel cell carcinoma have contributed to better defining the high-risk patients, which may require a more comprehensive approach to treatment. A multidisciplinary team approach to the overall management is crucial for the optimal treatment of patients with Merkel cell carcinoma. Surgery and radiotherapy play a fundamental role in the management of this tumor, with both associated with improved locoregional control and disease-free survival. The risk for systemic recurrence is quite high, with no truly validated prognostic factors to identify those patients who will experience a distant failure. For those that develop metastatic disease, adjuvant chemotherapy can be utilized with little benefit toward a longer survival. Newer treatment options examining the role of immunotherapy have shown great promise in ongoing clinical trials and will likely replace chemotherapy as the preferred treatment option for stage 4 Merkel cell carcinoma in the future.


Merkel cell carcinoma Polyomavirus Head and neck Merkel cell carcinoma Sentinel lymph node biopsy Immunotherapy Targeted therapies Biomarkers 



Complete lymph node dissection




Clinical trials


Disease-free survival


Head and neck




Large tumor antigen


Merkel cell carcinoma


Merkel cell polyomavirus


Nuclear factor of activated T cells


Natural killer


Overall survival


Death protein-1


PD-1 ligand


Radiation therapy


Surveillance, Epidemiology, and End Results


Sentinel lymphatic node biopsy


Small tumor antigen


Ultraviolet light


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Isabel Prieto
    • 1
    Email author
  • Teresa Pérez-de-la-Fuente
    • 2
  • M Susana Medina
    • 3
  • Beatriz Castelo
    • 4
  • Fernando Cassinello
    • 5
  • David Esteban
    • 1
  • Nuria Rodriguez-Salas
    • 4
  1. 1.Department of Radiation OncologyFundación Jiménez DíazMadridSpain
  2. 2.Department of Plastic SurgeryFundación Jiménez DíazMadridSpain
  3. 3.Department of DermatologyPríncipe de Asturias University HospitalMadridSpain
  4. 4.Department of Medical OncologyHospital Universitario La PazMadridSpain
  5. 5.Department of AnesthesiologyFundación Jiménez DíazMadridSpain

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