Would you offer adjuvant radiotherapy to a recurrent HPV-independent vulvar cancer located close to the anus, which was resected with very close (0.8 mm) margins?

I would favor RT and include the inguinal region as with local recurrence, there is about a 15% risk of nodal involvement.

Yes, adjuvant RT now, as others have stated.

Additionally, I would argue the patient probably would have benefited from adjuvant radiation at the time of her second diagnosis (first recurrence), assuming that these are truly local recurrences, and not new primaries in the setting of field cancerizat...

Yes, especially given multiple recurrences already and the close margins.

Yes. Based on the information provided, it is very likely that the patient will recur and hence, would recommend radiotherapy.