[Merkel cell carcinoma: current surgical approaches and multidisciplinary treatment].

Abstract

Merkel cell carcinoma (MCC) is a rare, aggressive cutaneous neuroendocrine tumor with poor prognosis, requiring precise surgical management within a multidisciplinary approach. We conducted a narrative review with a structured literature search in biomedical databases (PubMed, Embase, Scopus, Web of Science) and official guidelines (NCCN, ESMO). Thirty high-quality and clinically relevant articles were selected based on methodological rigor and applicability. Wide local excision with 1-2 cm margins remains the standard of care for localized disease. Sentinel lymph node biopsy should be performed in all clinically node-negative cases, and complete lymphadenectomy is reserved for patients with confirmed nodal involvement or symptomatic disease. While surgery is essential, it is insufficient alone and must be integrated into a multidisciplinary model involving accurate staging, oncologic follow-up, and immunotherapy in advanced stages. This review highlights the crucial role of the surgeon as an active member of the comprehensive care team to improve survival and quality of life in patients with MCC.