In what situations would you treat elective regional lymph nodes for a squamous cell carcinoma of the skin on the extremity/trunk that was clinically node negative?  

For example, for a squamous cell carcinoma of the forearm treated with Mohs surgery with negative margins, are there features that would lead you to electively treat the epitrochlear and/or axillary nodes, (e.g. size, DOI, PNI, or an immunosuppressed patient)?



Answer from: Radiation Oncologist at Academic Institution