Abstract
To the Editor: Determining excisional margins and proper selection of patients for adjuvant radiation therapy (aRT) are challenges in the management of Merkel cell carcinoma (MCC). For early-stage, localized MCC, the National Comprehensive Cancer Network guidelines recommend sentinel lymph node biopsy and either wide local excision with/without aRT or narrow-margin excision with aRT. If surgical margins are positive, re-excision or aRT is recommended.1 Risk factors for positive surgical margins and their impact on survival are incompletely explored in MCC, and thus, we investigated this in the National Cancer Database.
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