Would you recommend adjuvant radiation therapy to the locoregional lymph node basins for Merkel cell carcinoma (MCC) with a solitary macroscopically positive lymph node (LN) without ECE after lymph node dissection?

As always the need to prophylacticaly treat possible residual nodal disease is influenced by many factors. Histology a key factor. Merkle cell is usually one step ahead of treatment. In this case I would definitely treat the nodes at risk. I would also treat widely around the resected primary skin s...

Similar to melanoma, we have a higher threshold to treat nodes in the groin compared to H&N due to the higher lymphedema morbidity risk in the groin.

Following a comprehensive groin dissection, it is reasonable to watch the groin for a single small node positive MCC w/o ECE.

In the H&N, we offer POR...