When is adjuvant radiotherapy recommended for a high risk squamous cell carcinoma of the skin (non-H&N) if the tumor is resected with widely negative margins and there is no perineural invasion?  

Per NCCN, only +/close margins and +PNI are given as indications for adjuvant RT. However, are the presence of other risks factors considered to guide recommendations for adjuvant radiation (i.e. large tumor size >?cm, +LVSI, high grade, deep tumor invading into but not beyond subcutaneous fat)? Do multiple additional risk factors need to be present?



Answer from: Radiation Oncologist at Academic Institution