MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINES

Detalhes bibliográficos
Autor(a) principal: Teixeira, Vera
Data de Publicação: 2013
Outros Autores: Vieira, Ricardo, Julião, Maria José, Figueiredo, Américo
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.29021/spdv.71.1.120
Resumo: Introduction: Merkel cell carcinoma (MCC) is a rare cutaneous malignancy which incidence has tripled in the last 20 years, because of new pathologic techniques. Its mortality rates exceed those of melanoma, with signi- ficant associated morbidity and loco-regional metastasis. Material and methods: The authors reviewed the literature in order to provide clinical practice guidelines for the diagnosis and treatment of MCC. Results: Recently the American Joint Committee on Cancer has developed a staging system (TNM), which divides the MCC into 4 stages, depending on the degree of aggressiveness of the tumor. Surgery is the treatment of choice in the MCC approach, with surgical margins ranging between 1-2cm depending on the characteristics of the primary tumor. Currently consensus is the benefit of sentinel node biopsy, and the status of the sentinel node the most important prognostic factor. Adjuvant radiotherapy to the tumor bed and lymph node basis is of particular importance when associated with radical lympha- denectomy. Despite being sensitive to chemotherapy, stage IV MCC has a poor prognosis, with questionable benefit of chemotherapy. Conclusions: It is important to keep a low threshold of suspicion for the CCM, in order to optimize the treatment of this aggressive tumor.  KEYWORDS – Carcinoma, Merkel cell; Sentinel lymph node biopsy; Neoplasm staging; Practice guidelines.
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spelling MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINESCARCINOMA DE CÉLULAS DE MERKEL – NORMAS DE ORIENTAÇÃO CLÍNICAIntroduction: Merkel cell carcinoma (MCC) is a rare cutaneous malignancy which incidence has tripled in the last 20 years, because of new pathologic techniques. Its mortality rates exceed those of melanoma, with signi- ficant associated morbidity and loco-regional metastasis. Material and methods: The authors reviewed the literature in order to provide clinical practice guidelines for the diagnosis and treatment of MCC. Results: Recently the American Joint Committee on Cancer has developed a staging system (TNM), which divides the MCC into 4 stages, depending on the degree of aggressiveness of the tumor. Surgery is the treatment of choice in the MCC approach, with surgical margins ranging between 1-2cm depending on the characteristics of the primary tumor. Currently consensus is the benefit of sentinel node biopsy, and the status of the sentinel node the most important prognostic factor. Adjuvant radiotherapy to the tumor bed and lymph node basis is of particular importance when associated with radical lympha- denectomy. Despite being sensitive to chemotherapy, stage IV MCC has a poor prognosis, with questionable benefit of chemotherapy. Conclusions: It is important to keep a low threshold of suspicion for the CCM, in order to optimize the treatment of this aggressive tumor.  KEYWORDS – Carcinoma, Merkel cell; Sentinel lymph node biopsy; Neoplasm staging; Practice guidelines.Introdução: O carcinoma de células de Merkel (CCM) é considerado um tumor cutâneo raro, cuja incidência triplicou nos últimos 20 anos, em parte devido a uma maior acuidade diagnóstica. A taxa de mortali- dade ultrapassa a do melanoma, com importante morbilidade associada e metastização loco-regional. Material e métodos: Os autores reviram a literatura disponível com o intuito de fornecer normas de orientação clínica para o diagnóstico e tratamento do CCM. Resultados: Recentemente o American Joint Commitee on Cancer elaborou um sistema de estadiamento (TNM), que divide o CCM em 4 estadios (I-IV) consoante o grau de agressividade da neo- plasia. A cirurgia é a terapêutica de 1a linha na abordagem do CCM, com margens cirúrgicas que variam entre 1-2cm, consoante as características do tumor primário. Actualmente é consensual o benefício da biopsia do gânglio sentinela, sendo o status do gânglio sentinela o factor prognóstico mais importante. A radioterapia adjuvante no leito tumoral e nas cadeias ganglionares regionais assume particular importância associada à linfadenectomia radical. Apesar de se tratar de um tumor quimiossensível, o estadio IV do CCM tem prognóstico reservado, sendo discutível o benefício da quimioterapia. Conclusões: É importante manter um baixo limiar de suspeita para o CCM no sentido de optimizar o tratamento deste tumor agressivo. PALAVRAS-CHAVE – Carcinoma de células de Merkel; Biopsia de gânglio sentinela; Estadiamento; Normas de orientação clínica. Sociedade Portuguesa de Dermatologia e Venereologia2013-06-23T00:00:00Zinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://doi.org/10.29021/spdv.71.1.120oai:ojs.revista.spdv.com.pt:article/120Journal of the Portuguese Society of Dermatology and Venereology; Vol 71 No 1 (2013): Janeiro - Março; 23-32Revista da Sociedade Portuguesa de Dermatologia e Venereologia; v. 71 n. 1 (2013): Janeiro - Março; 23-322182-24092182-2395reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spdv.com.pt/index.php/spdv/article/view/120https://doi.org/10.29021/spdv.71.1.120https://revista.spdv.com.pt/index.php/spdv/article/view/120/109Teixeira, VeraVieira, RicardoJulião, Maria JoséFigueiredo, Américoinfo:eu-repo/semantics/openAccess2022-10-06T12:34:41Zoai:ojs.revista.spdv.com.pt:article/120Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:10:41.895185Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINES
CARCINOMA DE CÉLULAS DE MERKEL – NORMAS DE ORIENTAÇÃO CLÍNICA
title MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINES
spellingShingle MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINES
Teixeira, Vera
title_short MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINES
title_full MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINES
title_fullStr MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINES
title_full_unstemmed MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINES
title_sort MERKEL CELL CARCINOMA – CLINICAL PRACTICE GUIDELINES
author Teixeira, Vera
author_facet Teixeira, Vera
Vieira, Ricardo
Julião, Maria José
Figueiredo, Américo
author_role author
author2 Vieira, Ricardo
Julião, Maria José
Figueiredo, Américo
author2_role author
author
author
dc.contributor.author.fl_str_mv Teixeira, Vera
Vieira, Ricardo
Julião, Maria José
Figueiredo, Américo
description Introduction: Merkel cell carcinoma (MCC) is a rare cutaneous malignancy which incidence has tripled in the last 20 years, because of new pathologic techniques. Its mortality rates exceed those of melanoma, with signi- ficant associated morbidity and loco-regional metastasis. Material and methods: The authors reviewed the literature in order to provide clinical practice guidelines for the diagnosis and treatment of MCC. Results: Recently the American Joint Committee on Cancer has developed a staging system (TNM), which divides the MCC into 4 stages, depending on the degree of aggressiveness of the tumor. Surgery is the treatment of choice in the MCC approach, with surgical margins ranging between 1-2cm depending on the characteristics of the primary tumor. Currently consensus is the benefit of sentinel node biopsy, and the status of the sentinel node the most important prognostic factor. Adjuvant radiotherapy to the tumor bed and lymph node basis is of particular importance when associated with radical lympha- denectomy. Despite being sensitive to chemotherapy, stage IV MCC has a poor prognosis, with questionable benefit of chemotherapy. Conclusions: It is important to keep a low threshold of suspicion for the CCM, in order to optimize the treatment of this aggressive tumor.  KEYWORDS – Carcinoma, Merkel cell; Sentinel lymph node biopsy; Neoplasm staging; Practice guidelines.
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dc.source.none.fl_str_mv Journal of the Portuguese Society of Dermatology and Venereology; Vol 71 No 1 (2013): Janeiro - Março; 23-32
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