How would you evaluate the role for adjuvant radiation in a very young female (20s) with a localized vulvar SCC, HPV independent, status post hemivulvectomy?
Surgical pathology found close medial margin but no other adverse features. Would you favor omission, VBT, or EBRT?
Answer from: Radiation Oncologist at Community Practice
Either re-excision or observation provided no dVin at margin and at least a 3 mm negative margin for invasive disease.
Answer from: Radiation Oncologist at Community Practice
HPV-independent SCC in a young patient is a poor prognostic factor, therefore, I would be inclined to offer some kind of additional treatment. Anecdotally, I have offered observation, only to then react to recurrent disease.
However, would need to better understand close margin - is it 1 mm? ...