Topics:
Head and Neck Cancers • Radiation Oncology
Would you cover elective nodal regions in a patient with high-risk cutaneous SCC of the right medial forehead with clinically negative lymph nodes s/p WLE with graft?
If so, which nodal regions?
SCC measures 5.5 cm, 2.0 cm thickness, closest margin 0.2 cm (deep), high grade, PNI+, LVSI+. Lymphadenectomy was deferred and no SLNbx was performed. CT/MRI/PET negative for clinically involved nodes.
Answer from: Radiation Oncologist at Community Practice
This patient exhibits several adverse features that could warrant post-operative management. As a caveat, patient KPS and other factors may influence the decision point on if and what to treat. That said, the tumor size, thickness, and the presence of other high-risk features in aggregate (+PNI/LVSI...
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Answer from: Radiation Oncologist at Academic Institution
Yes. Ipsilateral parotid nodes, plus 1b, 2, and 3.
Answer from: Radiation Oncologist at Academic Institution
Our single institution study (Clinical Skin Cancer) of high risk cutaneous SCCa showed only depth of invasion was predictive of regional nodal mets (10% rate in patients with depth of invasion of 4 mm or greater) based on a sentinel node mapping. Neither recurrence, tumor size, LVSI, PNI, nor grade ...
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Radiation Oncologist at Phoenix CyberKnife and Radiation Oncology Center
A commercially available, 40 gene expression profi...
A commercially available, 40 gene expression profi...
Answer from: Radiation Oncologist at Community Practice
Would also include course of V1 to Meckel's cave given PNI.
Comments
Radiation Oncologist at Bon Secours Mercy Health
Morbidity might be too high but would depend on th...
Morbidity might be too high but would depend on th...
Radiation Oncologist at White Plains Hospital
Agree, these are nuanced decisions and depend on t...
Agree, these are nuanced decisions and depend on t...