What would you recommend for early stage vulvar cancer with close margins?

With negative sentinel LN's in an early stage patient, I would try to avoid the use of radiation if possible. Re-excision with a clear margin of 1-2 cm, extending to the deep perineal fascia, should be adequate to give a high rate of local control and cure, in the absence of other negative prognosti...

The value of RT in early stage vulvar cancer has recently been challenged in the series from Netherland where 3 mm margin was deemed to be adequate. More important factors for local recurrence was the presence of d VIN and lichen sclerosis at margin. That being said, we still consider RT for < 8 mm ...