How would you approach a patient with metastatic Merkel cell carcinoma to the axillary/supraclavicular lymph nodes of unknown primary?
Would you recommend locoregional radiation therapy or systemic or immunotherapy alone? If you would consider radiation therapy, what would be your recommend targets and dose-fractionation?
Answer from: Radiation Oncologist at Academic Institution
It's important to note that the first step is to thoroughly stage the patient - PET/CT (additional imaging as warranted) and a skin survey.
For a patient with a nodal-only disease, I would approach this as a potentially curative case. While it's possible that the risk of distant metastatic disease ...
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Answer from: Radiation Oncologist at Academic Institution
Node dissection, postop RT, and adjuvant chemo.