How would you manage a nodal recurrence of cutaneous SCC if the patient is unable to receive surgery for 6-8 weeks?

I’d first consider referring the patient to a center that could perform the operation, as it is standard of care for a patient with resectable cSCC with nodal metastases.

At some centers, there may be a clinical trial of neoadjuvant immunotherapy that could be considered.

If those options were not available, I think you have to consider this a patient with “unresectable” cSCC. In that scenario, I consider definitive RT (with or without drug therapy) standard of care. This is debatable, as there are no randomized trials of the best therapy for this patient population, but several single arm studies of radiotherapy and drug therapy have been conducted. In addition, there are several retrospective reports of radiotherapy alone for this patie...