7+ Year Member
Jan 18, 2013
Status (Visible)
  1. Attending Physician
Dear friends,
I have a 68 yo lady (diabetic and has hypertension) that was diagnosed of right vulvar SCC grade 1, pT1bpN0.
4cm lesion, 1cm Depth of invasion, no LVSI, all margins are negative > 8 mm except for urethral margin which is at 7 mm.
What do you do next:
1- observation
2- adjuvant RT to vulvar tumor bed only
3- adjuvant RT to pelvis only
4- adjuvant RT to pelvis and vulvar tumor bed


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10+ Year Member
Dec 22, 2010
Status (Visible)
It's a toss-up. Her local recurrence risk is 15-20%. Many will observe, many will treat with a local field only.


10+ Year Member
Dec 17, 2007
Status (Visible)
  1. Attending Physician
pN0 is based on sentinel lymph node dissection, I presume?

Her main risk factor for recurrence is the depth of invasion. I wouldn't be all too worried about the margins, there are contemporary reports showing a small risk of recurrence with margins around 5mm.

I'd observe.
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