Do you give adjuvant RT to vulva in a patients with node positive vulvar cancer and no high risk features for vulvar recurrence?

There is variation in practice. I tend to treat primary also along with nodal volume as long term data shows a 25- 35% risk of LR and a low 65% salvage rate. Data unknown is how much would RT reduce this and if these are true recurrences or new primary.

Te Grootenhuis et al., PMID 26428940