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?

Topics: Radiation Oncology • Melanoma/Skin Cancer

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

I would irradiate the axilla with 50 Gy in 25 fractions. I would not recommend completion lymphadenectomy, regardless of number of sentinel lymph nodes involved with carcinoma, or extranodal extension of carcinoma. A randomized controlled trial has demonstrated that 50 Gy in 25 fractions targeting c...

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Radiation Oncologist at Madigan Army Medical Center
Would you include the epitrochlear lymph nodes in ...

Radiation Oncologist at The Toledo Clinic
Also interested in this answer. Thank you.

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