Merkel Cell Carcinoma: Current Management and Controversies

Merkel cell carcinoma is a rare skin tumour with a poor outcome and high rates of both local and distant recurrence despite radical management. We review the management of local and locoregional disease, and the role of sentinel lymph node biopsy in staging. This overview aims to highlight some of the controversies regarding the current treatment of this disease, which seems to be on the increase. Data are conflicting as to whether there is any survival benefit from adjuvant primary site or regional nodal irradiation, partly due to the lack of prospective clinical trials. We also review the evolving role of primary radiotherapy and suggest areas where ongoing research is urgently required.