Andruska N, Fischer-Valuck BW, Mahapatra L, et al. - Researchers undertook this large multicenter retrospective cohort study to ascertain if larger clinical local excision (LE) margins and receipt of adjuvant radiotherapy are related to improvements in overall survival (OS) in patients suffering from localized Merkel cell carcinoma (MCC). The National Cancer Database was used to select adult patients with localized stage I or stage II MCC who had LE between January 1, 2004, and December 31, 2015. This analysis involved 6,156 patients with localized MCC (median age at diagnosis, 77 years [range, 27-90 years]; 2500 females [40.6%]). Per findings, improved OS was obtained in relation to LE clinical margins larger than 1.0 cm, and these improvements were identified to be independent of tumor subsite, receipt of adjuvant radiotherapy, positive pathologic margins, or adverse pathologic features for stage I to stage II MCC. The OS in patients with LE margins of 1.0 cm or smaller who were treated with adjuvant radiotherapy was shown to be similar to that noted in patients with larger LE margins who did not receive radiotherapy. The highest OS was observed in relation to the combination of LE clinical margins larger than 1.0 cm and adjuvant radiotherapy.