How would you approach adjuvant therapy for a fully resected vulvar carcinoma with a single positive lymph node?

There is not a simple answer to this question. In most cases, omitting adjuvant therapy is appropriate, but in certain cases, adjuvant radiation therapy + chemotherapy is advised, even in the presence of only a single positive lymph node. It has been over 30 years since Homesley and co-workers’ 1986...

Data, now 30-40 yrs old, noted that patients with only one positive node had a survival comparable to those with negative nodes.