Vulvar Cancer

GOG 205 treated vulvar cancer patients to a dose of 57.6 Gy to sites of gross disease, which is somewhat less than what is suggested in cases of defin...

3 Answers available

What is the appropriate timing for adjuvant radiation for vulvar cancer?

What is considered the optimal interval from time of excision, partial, or radical vulvectomy and/or nodal dissection to initiation of post-op RT?

1 Answer available

What is your recommended radiation field in early stage vulvar cancer (T1a-b) with myelosuppression, inconclusive SLNBx, and persistent positive margins?

Bone marrow preservation is important due to poor hematologic function. Chemotherapy is not possible as well.

2 Answers available

In patient s/p definitive chemoRT for vulvar cancer with complete response, how do you manage a non-healing vulvar defect if biopsy is negative for residual disease?

2 Answers available

How would you approach a vulvar SCC with extension to the anal sphincter and inguinal nodes, 10 years after definitive chemoRT+brachy for a cervical cancer?

2 Answers available

Do you recommend adjuvant radiation for a recurrent pT1bN0 vulvar carcinoma?

What factors would push towards treatment? The patient had recurrence of a pT1bN0 vulvar SCC within a year of original surgery. Re-resection shows aga...

3 Answers available

Would you offer radiation to a patient with extensive vulvar dysplasia not amenable to surgical resection and previously resected micro-invasive vulvar cancer in the setting of immunosuppression for solid organ transplant?

3 Answers available

Would you offer RT alone to an elderly woman with squamous cell carcinoma in-situ of the vulva, distal vagina, and periurethral area?

Treat as invasive disease with concurrent chemotherapy? Any non-radiation options for large in-situ disease? If RT, would you include at least inguina...

2 Answers available

Is adjuvant RT recommended for a Bartholin's gland SCC s/p piecemeal resection with deep invasion and negative ipsilateral LN dissection?

2 Answers available

How would you treat a recurrent, metastatic invasive Paget's disease of the vulva?

Initial treatment of the primary invasive Paget's disease of the vulva that was metastatic to inguinal lymph node included resection and chemoradiatio...

1 Answer available

What rectal dose constraints do you use for definitive chemoradiation for vulvar/vaginal cancer?

1 Answer available

How would you approach adjuvant therapy for a fully resected vulvar carcinoma with a single positive lymph node?

Margins widely negative - 1cm, and full bilateral inguinofemoral lymphadenectomy performed.

2 Answers available

Is it acceptable to treat vulvar cancers with split course radiation?

In an elderly woman who is not felt to be a good candidate for radical surgery is split course radiation alone an option for definitive intent radiati...

2 Answers available

What radiation dose/fractionation would you consider for palliation of an unresectable vulvar cancer that received previous definitive radiation therapy?

1 Answer available

How would you manage a woman with recurrent Paget's disease of the vulva, s/p resection, with most recent pathology showing multiple foci of early invasion?

Margins negative. Discussion included adjuvant RT versus observation and/or repeat resection with recurrence.

1 Answer available

What adjuvant treatment would you recommend for Stage III vulvar cancer s/p resection with a history of prior radiation treatment for vaginal cancer?

Vulvar cancer is well differentiated. Closest margin is 6mm. LVI is identified T1b N2c Vaginal cancer treated 20 yrs ago described as 5 cm in length...

2 Answers available

How do you treat a positive margin of vulvar Paget's after radical vulvectomy?

1 Answer available

In a patient with squamous vulvar cancer previously treated with cisplatin and radiotherapy and now with widely metastatic recurrence, would you initiate treatment with chemotherapy or consider immunotherapy?

CPS score is pending

2 Answers available

How do you approach treatment of vulvar cancer with bulky lymph node metastasis?

1 Answer available

Is radiation therapy a treatment option for refractory Paget's disease of the vulva extending onto skin of buttocks and anal margin?

2 Answers available

In the setting of vulvar cancer, do you perform complete inguinal lymphadnectomy when inguinal sentinel nodes demonstrate micrometastatic (<2mm) disease?

What if the sentinel nodes demonstrate macrometastatic disease?

1 Answer available

What would you recommend for early stage vulvar cancer with close margins?

Sentinel Lymph Nodes negative

2 Answers available

How do you approach ITCs in sentinel lymph node biopsy in a vulvar cancer patient?

2 Answers available

Can you omit the vulva from the radiation field in isolated LN recurrence several years after initial vulvectomy/nodal dissection without adjuvant RT?

The patient had an initial partial vulvectomy and nodal dissection 6 years prior to recurrence, with no adjuvant RT offered initially due to lack of c...

2 Answers available

How long would a vulvar cancer s/p definitive chemoradiotherapy, how long should the lesion be followed for regression before initiating biopsy or salvage surgery?

Should these patients be managed similar to p16 positive anal squamous cell carcinoma, and allowed six months or more for complete regression before c...

2 Answers available

What doses would you treat the primary and lymph nodes in node positive vulvar cancer patient with incidentally found focal SCC in a field of VIN3?

Surgeon is not planning vulvectomy, since biopsies showed 2 mm depth of invasion. Also tumor board felt dose to the primary site should be only about...

2 Answers available

Is it reasonable to only treat the inguinal nodes and not the pelvic nodes in an unresectable cT1cN0 vulvar SCC at the clitoris?

What would be factors that would indicate the need to include the pelvic nodes?

1 Answer available

What palliative radiation dose would you give to a patient with vulvar cancer who has an inguinal recurrence in a field previously irradiated with 45 Gy?

1 Answer available

When would a completion inguinofemoral node dissection followed by adjuvant RT (+/- chemo) be favored over definitive RT (+/- chemo) for SLN+ vulvar cancer?

1 Answer available

What is your recommended radiation field for early stage vulvar cancer with persistent positive margins (T1a-T1b)?

When should pelvic/inguinal lymph nodes be included?

2 Answers available

How do you manage moist desquamation when treating vulvar cancer?