Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-23T07:00:08.018Z Has data issue: false hasContentIssue false

Debate 50B - Should Adjuvant Radiation Therapy be Given to Patients with Single Node Positive Vulvar Cancer?

No

from Section VI - Vaginal and Vulvar Cancer

Published online by Cambridge University Press:  20 July 2023

Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
Get access

Summary

Inguino-femoral lymph node metastasis in vulvar cancer accounts for increased risk of recurrence and 50% decrease in survival. Adjuvant radiotherapy for single positive IFLN vulvar cancer has persisted as a controversial topic since the publication of GOG 37. Retrospective data from Germany indicates that there is no difference in survival for patients with single node positive vulvar cancer treated with adjuvant radiotherapy or observation. Radical surgery, even with SLNB, followed by radiotherapy can lead to devastating and difficult-to-treat complications including wound infections, lymphedema, pain, and bone fractures. Considering these complications, overall quality of life, and the limited data demonstrating improved survival benefit, it would be beneficial to withhold adjuvant radiotherapy for patients with single-positive IFLN vulvar cancer. Further studies aimed at understanding the molecular landscape and investigating targeted and immunotherapy for vulvar cancer will aid in the treatment of this complex cancer.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Woelber, L, et al. Prognostic role of lymph node metastases in vulvar cancer and implications for adjuvant treatment. Int J Gynecol Cancer 2012;22(3):503508.CrossRefGoogle ScholarPubMed
Homesley, HD, et al. Radiation therapy versus pelvic node resection for carcinoma of the vulva with positive groin nodes. Obstet Gynecol 1986;68(6):733740.Google ScholarPubMed
Mahner, S, et al. Adjuvant therapy in lymph node-positive vulvar cancer: the AGO-CaRE-1 study. J Natl Cancer Inst 2015;107(3):dju426.CrossRefGoogle ScholarPubMed
Fons, G, et al. Adjuvant radiotherapy in patients with vulvar cancer and one intra capsular lymph node metastasis is not beneficial. Gynecol Oncol 2009;114(2):343345.Google Scholar
Parthasarathy, A, et al. The benefit of adjuvant radiation therapy in single-node-positive squamous cell vulvar carcinoma. Gynecol Oncol 2006;103(3):10951099.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×