How would you manage the axilla in a patient with Merkel cell carcinoma of the left forearm with clinically negative, axillary sentinel node positive disease?  

Would you recommend axillary dissection, axillary dissection followed by adjuvant radiation, or axillary radiation alone? Does the number of positive sentinel lymph nodes, or other characteristics such as size or presence of ENE, alter your recommendation?

Answer from: Radiation Oncologist at Academic Institution
Radiation Oncologist at Madigan Army Medical Center
Would you include the epitrochlear lymph nodes in ...
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