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Topics:
Radiation Oncology • Gynecologic Cancers
Would you offer adjuvant radiotherapy to a recurrent HPV-independent vulvar cancer located close to the anus, which was resected with very close (0.8 mm) margins?
The patient is in her 70s, was first diagnosed with vulvar cancer two years ago, and underwent a radical vulvectomy with clear margins and negative lymph nodes. She has since experienced local recurrence twice, both treated surgically. Most recently, the tumor was located on the posterior portion of the vulva, very close to the anus. Proximity to the anus precluded further resection.
Given that the tumor is HPV-independent and considering the potential complication of the next surgery, would you recommend adjuvant radiation therapy?
Answer from: Radiation Oncologist at Academic Institution
Yes, adjuvant RT now, as others have stated.
Additionally, I would argue the patient probably would have benefited from adjuvant radiation at the time of her second diagnosis (first recurrence), assuming that these are truly local recurrences, and not new primaries in the setting of field canceriza...
Answer from: Radiation Oncologist at Academic Institution
Yes, especially given multiple recurrences already and the close margins.
Answer from: Radiation Oncologist at Academic Institution
Yes. Based on the information provided, it is very likely that the patient will recur and hence, would recommend radiotherapy.
Agree