Kroll2013

7+ Year Member
Jan 18, 2013
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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

Ty




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seper

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

Palex80

RAD ON
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Dec 17, 2007
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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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