For extremity rhabdomyosarcomas (hand) with positive epitrochlear and axillary lymph nodes, do you treat the lymph nodes or just the primary?  

Treatment of extremity RMS (either hand or foot) requires either resection or radiation for local treatment, in the setting of effective systemic therapy. There are good data in the literature showing that the primary tumor can be effectively irradiated, while retaining function and form so to avoid...