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Radiation Oncology • Gynecologic Cancers
How would you treat a patient who has an inguinal p16+ SCC lymph node of unknown origin?
Patient had a single 3cm node s/p excisional biopsy of the one node without nodal dissection. We have done anoscopy and a thorough GYN exam (including pap smear and endocervical curettage), all of which showed no evidence of disease. Additionally, we have a PET/CT and a CT scan of the pelvis with contrast showing no evidence of disease elsewhere.
Answer from: Radiation Oncologist at Academic Institution
We have published a 60% 5yr OS for SCCa of unknown primary. The two most likely primary sites are anal cancer and vulvar cancer. Please see my previous posts for anal cancer doses. I would treat this patient to the ipislateral inguinal external and common iliac nodes. Once could consider treatment o...
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Answer from: Radiation Oncologist at Academic Institution
The first step is to be extremely careful to rule out primary sites with very careful gyn exam with particular attention to the vulva and distal vagina as well as anoscopy and urethroscopy. EUA is often indicated. I would estimate that at least half the patients sent to us for unknown primary turn o...
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Radiation Oncologist at Steward Healthcare
Just have to mention since ordering this textbook ...
Just have to mention since ordering this textbook ...