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

  • from Section VI - Vaginal and Vulvar Cancer
  • Edited by Dennis S. Chi, Memorial Sloan-Kettering Cancer Center, New York, Nisha Lakhi, Richmond University Medical Center, Staten Island, Nicoletta Colombo, University of Milan-Bicocca
  • Book:
    50 Big Debates in Gynecologic Oncology
    Published online:
    20 July 2023
    Print publication:
    03 August 2023, pp 304-306

  • 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.