70 In a recent systematic review, researchers examined the benefits of adjuvant radiotherapy in women with node-positive vulvar cancer. The study, which focused on cases involving groyne lymph node metastases, highlighted radiotherapy’s potential to reduce recurrence rates and improve survival outcomes. The findings were published in the journal Oncology Reviews. Vulvar cancer, although rare, poses significant health risks, particularly when metastasis reaches the lymph nodes. The study revealed that patients undergoing adjuvant radiotherapy experienced fewer groyne recurrences than those who only had lymph node resection. Specifically, after six years, recurrence-free survival rates were notably higher in the radiotherapy group compared to those who underwent pelvic lymphadenectomy alone. This improvement was largely attributed to radiotherapy’s capacity to control locoregional tumour spread, which is often a precursor to further disease progression. Researchers analysed data from a randomised control trial (RCT) of 114 participants, who had all undergone radical vulvectomy and bilateral lymphadenectomy. They were then split into two groups: one received radiotherapy, while the other had intraoperative pelvic lymphadenectomy without subsequent radiotherapy. At the six-year follow-up mark, the radiotherapy group showed a cumulative cancer-related death rate of 29%, compared to 51% in the pelvic lymphadenectomy-only group. Additionally, long-term findings indicated a trend towards improved overall survival in patients receiving radiotherapy, with survival rates reported as 51% compared to 41% for those who did not undergo radiotherapy. Importantly, patients with a higher percentage of positive lymph nodes, particularly those with over 20% positive nodes, appeared to benefit the most. This subset experienced reduced recurrence rates and enhanced survival outcomes when radiotherapy was administered. While adjuvant radiotherapy shows promise, it does come with risks. Patients in the radiotherapy group reported slightly higher rates of late cutaneous toxicities, although the difference in chronic lymphoedema incidence was minimal between both groups. The study, however, was limited by its sample size, and the data was deemed to be of low to very low certainty. Consequently, the findings, although compelling, should be approached cautiously, emphasising the need for further research to confirm radiotherapy’s efficacy in this context. As it stands, the study’s conclusions support the consideration of adjuvant radiotherapy as a beneficial option for women with node-positive vulvar cancer, particularly those with high-risk profiles. It underscores the importance of personalised treatment plans, especially in cases where recurrence risks are significant.