Merkel-cell carcinoma: ESMO–EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up

Abstract

Merkel-cell carcinoma (MCC) is a rare primary neuroendocrine carcinoma of the skin. It affects predominantly older, fair-skinned Caucasians and exhibits aggressive behaviour with a high recurrence rate and a propensity for early metastasis.1 Despite new advances in therapies for MCC, the prognosis remains poor. With the incidence of MCC increasing rapidly across Europe, prompt diagnosis and effective and harmonised management are imperative for improving patient care.2 The European Parliament and the European Commission recommend treating patients with rare cancers in centres linked to the European Reference Network for Rare Adult Solid Cancers (EURACAN). In these referral centres with a high volume of MCC patients, the clinical experience of a multidisciplinary team (MDT) specialising in skin cancers guarantees better treatment outcomes and access to clinical trials. Therefore, the objective of this guideline is to provide a comprehensive reference for MCC, which is based on a critical evaluation of current evidence and opinion of European Society for Medical Oncology (ESMO) experts in partnership with EURACAN.