Same-Day Coordination of Mohs Surgery, Lymphoscintigraphy, and Sentinel Lymph Node Biopsy for Merkel Cell Carcinoma: A Single-Center Feasibility Report.
6 affiliations
- 1School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
- 2Department of Dermatology, Cleveland Clinic, Cleveland, OH 44195, USA.
- 3Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH 44196, USA.
- 4Department of Dermatology, Washington University in St. Louis, St. Louis, MO 63130, USA.
- 5Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH 44195, USA.
- 6Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH 44106, USA.
Abstract
Background/Objectives: Merkel cell carcinoma (MCC) is an aggressive neuroendocrine tumor, most commonly occurring on the head and neck. Incidence of MCC is rising with the aging population. Five-year overall survival (OS) for localized MCC is 50.6%; 5-year OS for patients with distant metastases is 13.5%. The purpose of this study is to determine if coordination of care for the treatment of MCC is logistically feasible, and provide a description of the patient population observed at this institution. Methods: All patients with MCC diagnosis from January 2012-June 2024 were identified at our tertiary care center. All patients with MCC were added to our non-melanoma skin cancer registry. Outcomes were compared between those treated with our "Merkel cell carcinoma in a day" (MIAD) protocol and those receiving the standard treatment protocol. Results: No significant differences were detected in the recurrence rate, transit metastasis, distant metastasis, and disease-specific death. Nodal metastasis was higher in the MIAD group (HR 4.94, 95% CI 1.08-22.6, p = 0.039, six events total). Both groups had similar times to treatment and treatment within 30 days of diagnosis. Conclusions: MCC is a rare and aggressive tumor, often exhibiting subclinical tumor spread. Mohs micrographic surgery ensures 100% peripheral and deep margin assessment, with potential for tissue sparing. With thoughtful coordination, lymphoscintigraphy can be completed on the same day as Mohs surgery followed by sentinel lymph node biopsy (SLNB) and reconstructive surgery.
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BibTeX
@article{ruesch2026sameday,
title = {{Same-Day Coordination of Mohs Surgery, Lymphoscintigraphy, and Sentinel Lymph Node Biopsy for Merkel Cell Carcinoma: A Single-Center Feasibility Report.}},
author = {Victoria H Ruesch and Justin Thrush and James F Bena and Claudia Ricotti and Melissa Piliang and Melissa McEnery-Stonelake and Basia Marie Michalski-McNeely and Jon Meine and Jennifer Lucas and Christine Poblete-Lopez and Shlomo Koyfman and Brian Gastman and Allison T Vidimos},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18193187},
url = {https://europepmc.org/article/MED/42882880},
note = {CC BY},
}
RIS
TY - JOUR
TI - Same-Day Coordination of Mohs Surgery, Lymphoscintigraphy, and Sentinel Lymph Node Biopsy for Merkel Cell Carcinoma: A Single-Center Feasibility Report.
AU - Victoria H Ruesch
AU - Justin Thrush
AU - James F Bena
AU - Claudia Ricotti
AU - Melissa Piliang
AU - Melissa McEnery-Stonelake
AU - Basia Marie Michalski-McNeely
AU - Jon Meine
AU - Jennifer Lucas
AU - Christine Poblete-Lopez
AU - Shlomo Koyfman
AU - Brian Gastman
AU - Allison T Vidimos
PY - 2026
DA - 2026/10/02
JO - Cancers
DO - 10.3390/cancers18193187
UR - https://europepmc.org/article/MED/42882880
AB - Background/Objectives: Merkel cell carcinoma (MCC) is an aggressive neuroendocrine tumor, most commonly occurring on the head and neck. Incidence of MCC is rising with the aging population. Five-year overall survival (OS) for localized MCC is 50.6%; 5-year OS for patients with distant metastases is 13.5%. The purpose of this study is to determine if coordination of care for the treatment of MCC is logistically feasible, and provide a description of the patient population observed at this institution. Methods: All patients with MCC diagnosis from January 2012-June 2024 were identified at our tertiary care center. All patients with MCC were added to our non-melanoma skin cancer registry. Outcomes were compared between those treated with our "Merkel cell carcinoma in a day" (MIAD) protocol and those receiving the standard treatment protocol. Results: No significant differences were detected in the recurrence rate, transit metastasis, distant metastasis, and disease-specific death. Nodal metastasis was higher in the MIAD group (HR 4.94, 95% CI 1.08-22.6, p = 0.039, six events total). Both groups had similar times to treatment and treatment within 30 days of diagnosis. Conclusions: MCC is a rare and aggressive tumor, often exhibiting subclinical tumor spread. Mohs micrographic surgery ensures 100% peripheral and deep margin assessment, with potential for tissue sparing. With thoughtful coordination, lymphoscintigraphy can be completed on the same day as Mohs surgery followed by sentinel lymph node biopsy (SLNB) and reconstructive surgery.
SN - 2072-6694
ER -