The impact of surgical excision modalities of Merkel cell carcinoma of the head and neck on recurrence, survival, and quality of life: A systematic review

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

European Annals of Otorhinolaryngology-Head and Neck Diseases Pub Date : 2026-06-01 Epub Date: 2026-05-13 DOI:10.1016/j.anorl.2026.01.012

M. Geoffroy, F. Alibert, M. Fadel, M. Samimi, S. Boucher

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引用次数: 0

Abstract

Introduction

Standard treatment for locoregional (stages I–III) Merkel cell carcinoma (MCC) includes wide local excision (WLE) with lymph node management. However, the optimal surgical approach remains debated, especially in the head and neck, where extensive excision may impair function and aesthetics, affecting patients’ health-related quality of life (HR-QoL), and delay postoperative radiotherapy (RT).

Objective

This systematic review aimed to evaluate the impact of surgical excision modalities — including surgical margins, Mohs micrographic surgery (MMS), and histological resection status — on recurrence and survival outcomes in head and neck MCC (HN-MCC). Secondary objectives included assessing morbidity and HR-QoL.

Materials and methods

A systematic search of Medline, Embase, and Web of Science identified studies on HN-MCC surgical treatments. Studies were categorized into a narrative review and an individual descriptive analysis of cases. Two independent reviewers performed study selection, data extraction, and risk-of-bias assessment.

Results

A total of 43 studies were included: 9 cohort studies, 10 case series, and 24 case reports. No randomized clinical trials were found. No superior technique was identified between MMS and WLE. No studies showed a statistical link between surgical margin categories or histological resection status and local control or survival outcomes. None of the cohort and case series studies reported data on HR-QoL in patients with HN-MCC.

Conclusion

Significant heterogeneity in available data limits definitive recommendations on surgical approaches for HN-MCC.

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头颈部默克尔细胞癌手术切除方式对复发、生存和生活质量的影响：系统综述。

简介：局部（I-III期）默克尔细胞癌（MCC）的标准治疗包括广泛的局部切除（WLE）和淋巴结管理。然而，最佳的手术方法仍然存在争议，特别是在头颈部，大面积切除可能会损害功能和美观，影响患者的健康相关生活质量（HR-QoL），并延迟术后放疗（RT）。目的：本系统综述旨在评估手术切除方式（包括手术切缘、莫氏显微手术（MMS）和组织学切除状态）对头颈部MCC （HN-MCC）复发和生存结果的影响。次要目标包括评估发病率和HR-QoL。材料和方法：对Medline， Embase和Web of Science进行系统搜索，确定了HN-MCC手术治疗的研究。研究分为叙述性回顾和个案的个别描述性分析。两名独立审稿人进行了研究选择、数据提取和偏倚风险评估。结果：共纳入43项研究：9项队列研究，10项病例系列研究，24例病例报告。未发现随机临床试验。在MMS和WLE之间没有发现更好的技术。没有研究显示手术切缘类型或组织学切除状态与局部控制或生存结果之间存在统计学联系。没有队列和病例系列研究报告了HN-MCC患者的HR-QoL数据。结论：现有数据的显著异质性限制了对HN-MCC手术入路的明确推荐。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Annals of Otorhinolaryngology-Head and Neck Diseases OTORHINOLARYNGOLOGY-

CiteScore

3.70

自引率

28.00%

发文量

审稿时长

12 days

期刊介绍： European Annals of Oto-rhino-laryngology, Head and Neck diseases heir of one of the oldest otorhinolaryngology journals in Europe is the official organ of the French Society of Otorhinolaryngology (SFORL) and the the International Francophone Society of Otorhinolaryngology (SIFORL). Today six annual issues provide original peer reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches and review articles giving most up-to-date insights in all areas of otology, laryngology rhinology, head and neck surgery. The European Annals also publish the SFORL guidelines and recommendations.The journal is a unique two-armed publication: the European Annals (ANORL) is an English language well referenced online journal (e-only) whereas the Annales Françaises d’ORL (AFORL), mail-order paper and online edition in French language are aimed at the French-speaking community. French language teams must submit their articles in French to the AFORL site. Federating journal in its field, the European Annals has an Editorial board of experts with international reputation that allow to make an important contribution to communication on new research data and clinical practice by publishing high-quality articles.