In vulvar cancer patients with a well lateralized primary s/p vulvectomyand ipsilateral LND meeting nodal-based criteria for adjuvant RT, would you consider RT to the ipsilateral groin and pelvis?  

If so, are there any lymph node cut-offs you would have in terms of lymph node number or pathological ECE before you would add contralateral RT? What about if the primary had risk factors (but still well-lateralized) requiring coverage of the entirety of vulva?

Answer from: Radiation Oncologist at Community Practice