Would you cover elective nodal regions in a patient with high-risk cutaneous SCC of the right medial forehead with clinically negative lymph nodes s/p WLE with graft?
If so, which nodal regions?
SCC measures 5.5 cm, 2.0 cm thickness, closest margin 0.2 cm (deep), high grade, PNI+, LVSI+. Lymphadenectomy was deferred and no SLNbx was performed. CT/MRI/PET negative for clinically involved nodes.
Answer from: Radiation Oncologist at Community Practice
This patient exhibits several adverse features that could warrant post-operative management. As a caveat, patient KPS and other factors may influence the decision point on if and what to treat. That said, the tumor size, thickness, and the presence of other high-risk features in aggregate (+PNI/LVSI...
Answer from: Radiation Oncologist at Academic Institution
Our single institution study (Clinical Skin Cancer) of high risk cutaneous SCCa showed only depth of invasion was predictive of regional nodal mets (10% rate in patients with depth of invasion of 4 mm or greater) based on a sentinel node mapping. Neither recurrence, tumor size, LVSI, PNI, nor grade ...
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Radiation Oncologist at Phoenix CyberKnife and Radiation Oncology Center A commercially available, 40 gene expression profi...