Would you offer adjuvant RT for a small merkel cell carcinoma of the lateral canthus with a close margin?

Yes. The low rates of local recurrence after excision that I am familiar with are all after a "wide" excision is performed. In our institutional analyses that demonstrated a low rate of local recurrence after surgery without adjuvant radiotherapy to the site of the resected primary tumor, the median...

Yes, with orthovoltage if available. I'd suggest collimate on the skin with a lead mask and lead corneal shield. Obtain PET to stage and electively treat regional nodes.