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
- 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 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: Epidemiology, diagnosis, histopathology, and treatment of rare histologies", section on 'Epidemiology'.)
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.
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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
- - Coexistent precancerous lesions or dermatoses
- 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