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Would you include the entire op bed (including flap) within the radiation field in a patient requiring a V-Y advancement flap for closure following a radical vulvectomy?
The positive margin was medial, from 9:00 to 12:00, near the vaginal introitus.
Answer from: Radiation Oncologist at Academic Institution
It depends on one's assessment of the risk of recurrence in the region of the flap. It sounds like the positive margin is pretty significant and situated at the vaginal introitus. Most likely, the area of the flap is at risk, but this assessment should be individualized. Assuming that the flap is he...
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Answer from: Radiation Oncologist at Community Practice
Yes generally include entire operative bed.
Answer from: Radiation Oncologist at Community Practice
Yes would include full flap in microscopic dose field prior to boost to positive margin provided flap is healthy and well vascularized. If prolonged healing/poor healing may compromise on full flap coverage to limit risk of dehiscence.