How would you approach an early inguinal recurrence after surgical resection of Merkel Cell carcinoma in the popliteal region?

I would make sure there is no distant metastases with a PET-CT. Would try to enroll this patient in a trial. Current approach if localized in surgery followed by radiation, but with availability of immunotherapy, I would recommend at least an adjuvant immunotherapy after surgery. No one knows if rad...

Postop RT and Med Onc eval for adjuvant chemo.