Debate persists on what to do for resected vulvar cancer with one pathologically involved node. That’s because the one trial we look to for answers enrolled little over 100 patients and used radiation techniques popular when Star Wars was breaking box office records...the first time. As a refresher, 4500-5000 rads post-op improved overall survival for women with vulvar cancer metastatic to inguinal nodes, but this was most notable for women with at least two involved nodes. This evidence is now bolstered by NCDB data from this millennium on almost 2800 women with node-positive vulvar cancer receiving oncologic resection and inguinal lymphadenectomy. Post-op radiation was significantly associated with better survival among women with either a single (HR 0.81) or >one (HR 0.59) involved node, as was chemoradiation among those with >one (HR 0.79)--but not just one--involved node. TBL: NCDB data supports adjuvant radiation to improve survival in women with resected vulvar cancer metastatic to one or more nodes. | Rydzewski, Radiother Oncol 2018


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