<prompt> Which of these cases of ca vulva has the poorest prognosis?Large tumour sizepositive inguino-femoral lymph nodespositive pelvic lymph nodesinvolvement of lower 13rd of vagina  <response>: 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 