How long can a patient with newly diagnosed merkel cell carcinoma wait for wide local excision with sentinel node biopsy?

If I can't get them in with a surgical oncologist for the lymph node would it be better to do the wide local excision in my office immediately and risk disturbing the lymphatics?

2 Answers

Mednet Member

Dermatology · Dermatology & Laser Center

Answered on

A recent study I read on this same question regarding sentinel node biopsy (SNB) performed after melanoma wide excision found that the sentinel node could still be found just fine. And I have found that in practice a number of times when I wide-excised obvious melanomas at first presentation visit. So this should extrapolate to Merkel cell CA. Given the dire difference in survival with either of these cancers with vs without metastasis, it seems that adequate excision should be performed ASAP if...

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Mednet Member

Dermatology · Dept Dermatology Jefferson Medical College

Answered on

I agree, WLE can be followed by SLN Bx if melanoma data applies (and I think it does).

There is also support for local XRT to the general area following excision.

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