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?

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...

Yes. Ipsilateral parotid nodes, plus 1b, 2, and 3.

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 ...

Would also include course of V1 to Meckel's cave given PNI.