When would you recommend definitive radiation or surgery + PORT for a resectable skin cancer metastatic to the parotid?  

Surgery and adjuvant radiotherapy based on the experience of many groups show superior outcomes in this situation.  I am pretty sure this topic is not up for debate. The only exception might be Merkel cell carcinoma, but otherwise, in almost all skin cancers I can think of, this is the preferre...

Surgery and postop RT unless medically inoperable or unsuitable for a gross total resection. The control rate for RT alone is a lot lower.

Surgery and PORT is the current standard treatment in our center. However, I am not aware of robust data that supports the superiority of primary surgery over definitive RT+/- chemo. In my humble opinion there are just not enough patients treated with definitive RT to have a reasonable comparison. I...