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?
1 Answer
Mednet MemberInvited Expert
Radiation Oncology · Memorial Sloan Kettering Cancer Center
Answered on · Updated on
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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