Het merkelcelcarcinoom: nieuwe Europese richtlijn

Merkel cell carcinoma (MCC) is an aggressive, neuroendocrine tumor of the skin. Its incidence has increased in the last decades, and in The Netherlands between 150 to 200 new patients are diagnosed each year. A core or punch biopsy is essential for the diagnosis, without the need for diagnostic excision. Treatment of the primary tumor consists of surgical resection with 1cm margin, often followed by adjuvant radiotherapy when the tumor diameter is >1cm. A sentinel node procedure is also standard of care with surgical resection. Locoregional metastasized MCC is treated with surgery, usually with a lymph node dissection, followed by radiotherapy. For distant metastases, the checkpoint inhibitor avelumab is now preferred as first line treatment over cytotoxic chemotherapy. The 5-year overall survival for stage I/II is 51%, 35% for stage III and 14% for stage IV disease. In 2022 a new European consensus-based guideline has been published, which we will discuss in this article.