Top Clinical Insights: Merkel Cell Carcinoma: How I Do It
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Clinical Practice
- Initial management and staging work-up after Merkel Cell diagnosis includes: complete skin and lymph node exam, whole body PET CT, and labs for AMERK (antibody titers for MCPyV oncoproteins) and ctDNA (circulating tumor DNA).
- Lymph node biopsy is always required after Merkel Cell diagnosis unless the biopsy results would not change the treatment (for example if that patient had many other comorbidities).
- Frequent follow-up after definitive therapy is recommended due to high rates or recurrent disease. Merkel Cell Carcinoma recurs in ~40% of patients within 5 years and 90% of recurrences occur within the first two years.