Brazilian Society of Surgical Oncology recommendations on Merkel cell carcinoma surgical treatment
Rattachement africain : us, br. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Merkel cell carcinoma (MCC) is a rare neuroendocrine skin cancer with poor 5-year survival rates. Surgery and radiation are the current first-line treatments for local and nodal disease. OBJECTIVES: The Brazilian Society of Surgical Oncology developed this document aiming to guide the surgical oncology role in multimodal MCC management. METHODS: The consensus was established in three rounds of online discussion, achieving consensus on specific topics including diagnosis, staging, treatment, and follow-up. RESULTS: Patients suspected of having MCC should undergo immunohistochemical examination and preferably undergo pathology review by a dermatopathologist. Initial staging should be performed with dermatologic and nodal physical examination, combined with complementary imaging. Whole-body imaging, preferably with positron emission tomography (PET) or computed tomography (CT) scans, are recommended. Due to the need for multidisciplinary approaches, we recommend that all cases should be discussed in tumor boards and referred to other specialties as soon as possible, reducing potential treatment delays. We recommend that all patients with clinical stage I or II may undergo local excision associated with sentinel lymph node biopsy. The decision on margin size should consider time to recovery, patient's comorbidities, and risk factors. Patients with positive sentinel lymph nodes or the presence of risk factors should undergo postoperative radiation therapy at the primary site. Exclusive radiation is a viable option for patients with low performance. Patients with positive sentinel lymph node biopsy should undergo nodal radiation therapy or lymphadenectomy. In patients with nodal clinical disease, in addition to primary tumor treatment, nodal radiation therapy and/or lymphadenectomy are recommended. Patients with advanced disease should preferably be enrolled in clinical trials and discussed in multidisciplinary meetings. The role of surgery and radiation therapy in the metastatic/advanced setting should be discussed individually and always in tumor boards. CONCLUSION: This document aims to standardize a protocol for initial assessment and treatment for Merkel cell carcinoma, optimizing oncologic outcomes in middle-income countries such as Brazil.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Brazilian Society of Surgical Oncology recommendations on Merkel cell carcinoma surgical treatment
- Date Crossref
- 06/06/2024
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Brigham and Women's Hospital Department of Medicine pays non établi dans la noticeÉtablissement de santé
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Harvard University pays non établi dans la noticeUniversité ou école supérieure
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AC Camargo Hospital pays non établi dans la noticeÉtablissement de santé
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Faculdade de Ciências Médicas de Minas Gerais pays non établi dans la noticeUniversité ou école supérieure
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Santa Casa de Misericórdia de Marília pays non établi dans la noticeÉtablissement de santé
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Universidade Federal de Juiz de Fora Department of Surgical Oncology pays non établi dans la noticeUniversité ou école supérieure
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Beneficência Portuguesa de São Paulo pays non établi dans la noticeOrganisation à but non lucratif
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Hospital São Paulo pays non établi dans la noticeÉtablissement de santé
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Santa Casa Hospital pays non établi dans la noticeÉtablissement de santé
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Hospital Sírio-Libanês pays non établi dans la noticeÉtablissement de santé
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Universidade de São Paulo pays non établi dans la noticeUniversité ou école supérieure
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Instituto Nacional de Câncer - INCA pays non établi dans la noticeÉtablissement de santé
Department of Medicine — Brigham and Women's Hospital, Harvard University et AC Camargo Hospital, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.