For clinically node negative large squamous cell carcinomas of the scalp vertex, would you electively treat the nodes?  

In most situations, no.  I might consider it for a patient coming in for adjuvant radiotherapy to the primary site, if I do not anticipate that the patient would be able to undergo a salvage therapeutic lymphadenectomy over the next 3-4 years because of medical comorbidity.  The rationale...