How would you evaluate the right inguinofemoral lymph nodes in a female patient in her 30s with a 4 mm midline SCC of the vulva (depth of invasion 1.45 mm) and a PET-positive enlarged left inguinal node, for whom you plan to debulk the left inguinofemoral lymph nodes?  

Sentinel evaluation of right groin nodes at the same time as left groin debulking. 

Both GROINSS V1 and GOG 173 excluded patients with a clinically suspicious inguinal node. Although they defined this as suspicious by physical exam, I include pre-operative PET imaging in my decision-making. In a patient with a unilateral enlarged, PET-positive inguinal node, I would do a full ingui...