Squamous cell carcinoma of the vulva: Staging and surgical treatment
- 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
- Director, Stanford Women's Cancer Center
- Stanford Comprehensive Cancer Institute
- Chair, Department of Obstetrics & Gynecology
- Stanford University School of Medicine
- 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
- Professor of Gynecologic Oncology
- University of Washington
- 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
- Clinical Co-Director, Gynecologic Oncology
- Founder and Director, The Oncology Sexual Health Clinic
- Massachusetts General Hospital Cancer Center
- Associate Professor of Medicine
- Harvard Medical School
- 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
- Senior Deputy Editor — UpToDate
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Clinical Instructor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
Vulvar cancer is the fourth most common gynecologic cancer in high-resource countries and comprises approximately 5 to 6 percent of malignancies of the female genital tract. Although various histologic subtypes of vulvar cancer exist, the vast majority are squamous cell carcinoma (SCC). (See "Vulvar cancer: Clinical manifestations, diagnosis, and pathology", section on 'Epidemiology and risk factors'.)
This topic discusses the staging, treatment, and prognosis of women with vulvar SCC. The clinical presentation, diagnosis, and pathology of vulvar cancer; medical therapy; the techniques for radical vulvectomy; and the management of other histologies are reviewed separately.
●(See "Radical vulvectomy".)
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- VULVAR ANATOMY
- MODE OF SPREAD
- PRETREATMENT EVALUATION
- Ability to tolerate treatment
- Other HPV-associated diseases
- STAGING AND SURGICAL TREATMENT
- Staging system
- Clinical staging
- - Physical examination
- - Imaging studies
- Vulvar excision
- - Treatment of positive or narrow margins
- Inguinofemoral lymph nodes
- - No palpable groin nodes on examination
- Inguinofemoral lymphadenectomy
- - Unilateral versus bilateral
- - Patients who will receive RT
- Sentinel node biopsy
- - Palpable groin nodes on examination
- Nodal debulking
- ADJUVANT THERAPY
- DISEASE THAT CANNOT BE MANAGED SURGICALLY
- POSTTREATMENT SURVEILLANCE
- SUMMARY AND RECOMMENDATIONS