Squamous cell carcinoma of the vulva: Medical therapy and prognosis
- Amer Karam, MD
Amer Karam, MD
- Clinical Associate Professor
- Associate Director and Director of Outreach
- Division of Gynecologic Oncology
- Department of Obstetrics and Gynecology
- Stanford University School of Medicine
- Jonathan S Berek, MD, MMS
Jonathan S Berek, MD, MMS
- Laurie Kraus Lacob Professor
- Stanford University School of Medicine
- Fellow, Stanford Distinguished Careers Institute
- Director, Stanford Women's Cancer Center
- Senior Scientific Advisor, Stanford Cancer Institute
- Andrea L Russo, MD
Andrea L Russo, MD
- Assistant Professor
- Harvard Medical School
- Department of Radiation Oncology
- Massachusetts General Hospital
- Section Editors
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Department Chair, Gynecologic Oncology
- University of Washington Medical Center
- Arno J Mundt, MD
Arno J Mundt, MD
- Section Editor — Radiation Therapy
- Chairman of Radiation Oncology
- University of California, San Diego
- Don S Dizon, MD, FACP
Don S Dizon, MD, FACP
- Section Editor – Gynecologic Oncology
- Head of Women's Cancers, Lifespan Cancer Institute
- Director of Medical Oncology, Rhode Island Hospital
- Associate Professor of Medicine, Warren Alpert Medical School of Brown University
- Deputy Editors
- Sadhna R Vora, MD
Sadhna R Vora, MD
- Deputy Editor — Oncology
- Instructor in Medicine
- Harvard Medical School
- Sandy J Falk, MD, FACOG
Sandy J Falk, MD, FACOG
- Director, Editorial Relations — UpToDate
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Instructor of Obstetrics, Gynecology and Reproductive Biology, Part-time
- Harvard Medical School
Vulvar cancer is the fourth most commonly occurring gynecologic cancer in the United States, with approximately 6000 new cases each year . Most vulvar cancers are squamous cell carcinoma (SCC).
This topic discusses the medical treatment and prognosis of women with vulvar SCC, both for those who are receiving adjuvant therapy after surgical treatment and for those who are not surgical candidates. The staging and surgical management of vulvar cancer is discussed elsewhere. (See "Squamous cell carcinoma of the vulva: Staging and surgical treatment".)
The clinical presentation, diagnosis, and pathology of vulvar cancer; the techniques for radical vulvectomy and radiation therapy; and the management of other histologies are also reviewed separately.
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- PATIENT SELECTION
- ADJUVANT THERAPY
- Node-negative disease
- Node-positive disease
- - Benefit of adjuvant treatment
- - Chemoradiation versus RT alone
- - Extent of radiation treatment
- DISEASE THAT CANNOT BE MANAGED SURGICALLY
- Unresectable, locally advanced disease
- - Primary treatment
- - Management after primary treatment
- Patients who are medically frail
- Distant metastases
- POSTTREATMENT SURVEILLANCE
- Management of recurrence
- - Local recurrence
- - Distant recurrence
- SUMMARY AND RECOMMENDATIONS