How would you manage the axilla in a patient with Merkel cell carcinoma of the left forearm with clinically negative, axillary sentinel node positive disease?

I would irradiate the axilla with 50 Gy in 25 fractions. I would not recommend completion lymphadenectomy, regardless of number of sentinel lymph nodes involved with carcinoma, or extranodal extension of carcinoma. A randomized controlled trial has demonstrated that 50 Gy in 25 fractions targeting c...