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?

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If this patient undergoes potentially curative radiation therapy, would you recommend adjuvant immunotherapy off trial (assuming no trial is available)

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2 Answers

Mednet Member

Radiation Oncology · Yale School of Medicine

Answered on

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 i...

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Mednet MemberInvited Expert

Radiation Oncology · University of Florida

Answered on

Node dissection, postop RT, and adjuvant chemo.

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