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Radiation Oncology • General Radiation Oncology
When would you offer post-operative therapy to a resected non-melanomatous skin cancer with a solitary positive node?
For instance, should post-operative radiation therapy be offered a patient with a 4 cm malar SCCA, resected with negative margins, no PNI, and a complete neck dissection including parotdectomy demonstrating a single positive level IB lymph node with no ECE?
Answer from: Radiation Oncologist at Academic Institution
I treat them all. If they are fit enough for surgery, their prognosis is good enough to treat.
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Answer from: Radiation Oncologist at Academic Institution
If the lymph node is smaller than 3 cm, then there might be a case to forgo adjuvant lymph node basin radiotherapy based on this study:Ebrahimi et al., PMID 21472887However, one would want to confirm that an adequate lymphadenectomy and pathologic review of the specimen was performed. Also, consider...
Answer from: Radiation Oncologist at Community Practice
The ASTRO skin carcinoma guideline (Likhacheva et al., PMID 31831330) recommends postoperative radiotherapy for clinically node-positive patients with the exception of single <3 cm cervical node without ECE (Table 4, #1; strong recommendation; moderate quality of evidence).I would treat for a 4 c...
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Radiation Oncologist at CCare
It sounds like in the question the primary was 4cm...
It sounds like in the question the primary was 4cm...