The unified clinical protocol for primary and specialized medical care "Merkel cell carcinoma" (order of the Ministry of Health of Ukraine No. 437 dated 02.04.2026) has been added to the Register of Medical Technological Documents – a rare non-melanoma type of skin cancer.
The document establishes unified approaches to the diagnosis, treatment and further management of patients, based on the principles of evidence-based medicine and current international recommendations.
Merkel cell carcinoma is a rare neuroendocrine skin tumor with an aggressive course, a high risk of recurrence and early metastasis.
Possible causes include: Merkel cell polyomavirus infection, exposure to ultraviolet radiation and states of immunosuppression (in particular in patients with HIV or after transplantation).
The protocol provides for a comprehensive approach to treatment, which includes surgery, radiation therapy and modern systemic immunotherapy. A clear algorithm for post-treatment follow-up with regular clinical and instrumental examinations has also been defined, especially in the first years, when the risk of recurrence is highest.
For doctors, the document is a practical tool containing clear recommendations on:
- primary medical care and early detection
- current approaches to diagnosis
- treatment tactics at different stages, including inoperable forms
- organisation of symptomatic and palliative care
- follow-up monitoring of patients
For patients, the implementation of the protocol means access to current treatment methods, in particular immunotherapy, timely detection of recurrences and increased chances of long-term remission.
The protocol was developed on the basis of an evidence-based clinical guideline. Methodological and informational support for the development was provided by specialists of the State Expert Center of the Ministry of Health of Ukraine.
The text of the protocol and the clinical guideline can be found at the link https://www.dec.gov.ua/mtd/karczynoma-z-klityn-merkelya/
