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How would you treat bilateral groin recurrence of vulvar small cell neuroendocrine carcinoma in a patient who has previously had pelvic and groin radiation?
Pt underwent vulvectomy (pT1b) followed by adjuvant Cisplatin/Etoposide 4 cycles, completed 1 year ago. She had chemoradiation 5 years ago with concurrent Xeloda/MMC for anal cancer.