In vulvar cancer patients with a well lateralized primary s/p vulvectomy and ipsilateral LND meeting nodal-based criteria for adjuvant RT, would you consider RT to the ipsilateral groin and pelvis?

If so, are there any lymph node cut-offs you would have in terms of lymph node number or pathological ECE before you would add contralateral RT? What about if the primary had risk factors (but still well-lateralized) requiring coverage of the entirety of vulva?

Answer from: Radiation Oncologist at Community Practice

Risk of contra lateral node involvement for lateralized lesion is a function of the size of tumor, thickness of tumor and number of positive nodes in the ipsilateral groin (>2 node). If the contralateral node has not been assessed by dissection or SNLB then I would treat both groin...

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In vulvar cancer patients with a well lateralized primary s/p vulvectomy and ipsilateral LND meeting nodal-based criteria for adjuvant RT, would you consider RT to the ipsilateral groin and pelvis?

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