Which of these cases of ca vulva has the poorest prognosis?: (A) Large tumour size, (B) positive inguino-femoral lymph nodes, (C) positive pelvic lymph nodes, (D) involvement of lower 1/3rd of vagina
Answer is C. The single most impoant prognostic factor is lymph node status:5-year survival without groin node metastases is greater than 90%; with groin node metastases, 5-year survival is 50%. Inguino-femoral lymph nodes are involved in stage iii whereas pelvic and other lymph nodes are involved in stage iv A and hence pelvic lymph nodes will have poorer prognosis