This study compared outcomes of Mohs micrographic surgery versus wide local excision (WLE) for Merkel cell carcinoma, focusing on local recurrence, metastatic rates, and overall survival. The meta-analysis included multiple retrospective studies and demonstrated that Mohs surgery achieves at least equivalent, and possibly superior, local control compared to WLE for MCC. The findings support including Mohs as a surgical option in MCC management guidelines, particularly when negative margins are difficult to achieve with standard excision.

Meta-analytic evidence supports Mohs surgery as achieving equivalent or superior local control versus WLE for MCC.

Complete margin assessment via Mohs may be particularly valuable in MCC given the tumor's tendency for subclinical extension.

Surgical approach selection for MCC should balance margin control with the need for sentinel lymph node biopsy staging.