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If a patient has a negative SLN, they do not require any further nodal treatment. The isolated groin recurrence risk is 2.5%3.
The current consensus is that for midline lesions (<2cm from the midline), it is reasonable to omit a full inguinofemoral lymph node dissection in the
contralateral side to a positive sentinel node when that sentinel node was
negative in that contralateral groin. Lateral lesions (>2cm from the midline)
only need assessment of the ipsilateral groin5.
1. The primary vulvar lesion
2. The inguinofemoral lymph nodes
Lymph node status is the most important prognostic factor. Patients with one microscopically positive node have a prognosis similar to FIGO stage 1. In women with 3 or more positive nodes, the 5 year survival is below 50%7.
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