When would a completion inguinofemoral node dissection followed by adjuvant RT (+/- chemo) be favored over definitive RT (+/- chemo) for SLN+ vulvar cancer?   

The interim analysis of the GROINSS-V II trial showed a recurrence in 12.2% (10/82) of patients treated with radiation in the setting of positive sentinel lymph node biopsy for vulvar cancer. On subset analysis the risk of nodal recurrence was 2.2% for micrometastases (< or = 2 mm) and 20% f...