Abstract
Vulval cancer is a rare gynaecological cancer, predominantly seen in postmenopausal
women. It accounts for about 4% of gynaecological malignancies. Most women present
with vulval symptoms such as a painful lump, ulcer or itching, although some may be
asymptomatic. It should be managed in experienced cancer centres where relevant expertise
and experience is available to provide multidisciplinary, individualized care. Wide
local excision of the lesion, usually with surgical staging of groin nodes through
separate incisions is recommended for early disease. Locally advanced vulval cancers
require complex and highly individualized treatment, which may be a combination of
radical excision with reconstruction with or without radiotherapy. Sentinel lymph
node assessment for staging is now standard of care, replacing en-bloc inguinofemoral
lymphadenectomy for surgical staging of smaller, early-stage tumours, and groin dissection
is omitted in these women if sentinel node biopsy is negative (GROINSS-V I study).
Recent GROINSS-V II study has shown that radiotherapy is a safe alternative in patients
with sentinel lymph node micro metastases (≤2 mm) with low groin recurrence rate and
lower treatment-related morbidity.
Keywords
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Further reading
- Sentinel lymph node biopsy in vulvar cancer: systematic review, meta-analysis, and guideline recommendations.Gynecol Oncol. 2015 May 1; 137: 351-361
- Vulval cancer.in: Berek J.S. Hacker N.F. Berek and Hacker's gynecologic oncology. Lippincott Williams & Wilkins, 2010: 576-592
- British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: recommendations for practice.Eur J Obstet Gynecol Reprod Biol. 2020 Sep; 252: 502-525
- Radiotherapy versus inguinofemoral lymphadenectomy as treatment for vulvar cancer patients with micrometastases in the sentinel node: results of GROINSS-V II.J Clin Oncol. 2021 Nov 10; 39: 3623-3632
- Shafi M. Bolton H. Gajjar K. Gynaecological oncology for the MRCOG. Cambridge University Press, 2018 Apr 19
- Sentinel nodes in vulvar cancer: long-term follow-up of the Groningen International Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I.Gynecol Oncol. 2016 Jan 1; 140: 8-14
Article info
Publication history
Published online: November 08, 2022
Identification
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© 2022 Published by Elsevier Ltd.
