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

PET CT. Plan definitive chemo (weekly cisplatinum) with IMRT, with a dose of about equivalent dose of 66 Gy to GTVs. Reassess after 6-8 weeks for excision or bx of any residual disease. Dose-Escalated Intensity Modulated Radiation Therapy in Patients with Locally Advanced Vulvar Cancer- Does It I...