Merkel cell carcinoma (MCC), diagnosed primarily in the elderly white population, is an uncommon, clinically aggressive cutaneous malignancy with a high rate of local, regional, and distant recurrence. During the last 2 decades of the 20th century, the incidence of MCC more than tripled, a trend that is expected to continue with an increasingly aging population.1
Despite its rarity, the increasing incidence and aggressive nature of MCC have brought attention on this disease and revealed a wide variability in the treatment and management of patients diagnosed with this malignancy. Patients with MCC may have very different work-up, treatment, and follow-up depending on the institution, physician, and specialty providing their care. These inconsistencies highlight the importance of having best evidence-based treatment guidelines. Unfortunately, prospective randomized clinical trials are extremely limited because of the rarity of the disease, necessitating that guidelines be based on best available evidence and expert consensus opinion. Multidisciplinary management to establish consensus recommendations for individualizing patient care within the framework of evidence-based guidelines constitutes the optimal treatment model within the existing limitations. This article discusses the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for MCC, including the importance of multidisciplinary management, and highlights the implementation of these guidelines in the multidisciplinary MCC program at the University of Michigan (UM).
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