Treatment Options for Stage I and II Merkel Cell Carcinoma

Margin-negative local excision, attempting to maintain function.

Surgical nodal evaluation, typically by SLN procedure initially, may be considered for patients with significant risk of nodal disease. Completion of the nodal dissection may be considered if positive lymph nodes are found, which would upstage the patient's cancer to stage III.

Local radiation therapy may be considered if there is concern about the primary tumor excision margins. Regional radiation therapy may be considered if the nodal staging procedure is incomplete or omitted. For sites where the location of primary regional lymph nodes may be uncertain (e.g., mid-back), regional-node field selection is problematic.

Enrollment in clinical trials is encouraged.