Merkel cell cancer staging

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Merkel cell cancer Microchapters


Patient Information


Historical Perspective




Differentiating Merkel Cell Cancer from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis



History and Symptoms

Physical Examination

Laboratory Findings


Other Imaging Findings

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Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2] Ahmad Al Maradni, M.D. [3]


The staging of merkel cell cancer is based on the TNM staging system.


Stage Primary Tumor (T) Lymph Node (N) Metastasis (M)
0 In situ
IA ≤2 cm
IB ≤2 cm
  • Nodes negative by clinical exam (no pathologic node exam performed)
IIA >2 cm
  • Nodes negative by pathologic exam
IIB >2 cm
  • Nodes negative by clinical exam (no pathologic node exam performed)
IIC Invades bone, muscle and cartilage
IIIA Any size tumor (includes invading tumors)
IIIB Any size tumor (includes invading tumors) Positive for:
  • Macrometastasis
IV Any size tumor (includes invading tumors)


  1. Harms KL, Healy MA, Nghiem P, Sober AJ, Johnson TM, Bichakjian CK, Wong SL (October 2016). "Analysis of Prognostic Factors from 9387 Merkel Cell Carcinoma Cases Forms the Basis for the New 8th Edition AJCC Staging System". Ann. Surg. Oncol. 23 (11): 3564–3571. doi:10.1245/s10434-016-5266-4. PMID 27198511.
  2. Lemos BD, Storer BE, Iyer JG, Phillips JL, Bichakjian CK, Fang LC, Johnson TM, Liegeois-Kwon NJ, Otley CC, Paulson KG, Ross MI, Yu SS, Zeitouni NC, Byrd DR, Sondak VK, Gershenwald JE, Sober AJ, Nghiem P (November 2010). "Pathologic nodal evaluation improves prognostic accuracy in Merkel cell carcinoma: analysis of 5823 cases as the basis of the first consensus staging system". J. Am. Acad. Dermatol. 63 (5): 751–61. doi:10.1016/j.jaad.2010.02.056. PMC 2956767. PMID 20646783.
  3. Foote M, Veness M, Zarate D, Poulsen M (September 2012). "Merkel cell carcinoma: the prognostic implications of an occult primary in stage IIIB (nodal) disease". J. Am. Acad. Dermatol. 67 (3): 395–9. doi:10.1016/j.jaad.2011.09.009. PMID 22030017.
  4. Rastrelli M, Ferrazzi B, Cavallin F, Chiarion Sileni V, Pigozzo J, Fabozzi A, Tropea S, Vecchiato A, Costa A, Parisi A, Rossi CR, Del Fiore P, Alaibac M (September 2018). "Prognostic Factors in Merkel Cell Carcinoma: A Retrospective Single-Center Study in 90 Patients". Cancers (Basel). 10 (10). doi:10.3390/cancers10100350. PMC 6210570. PMID 30249978.