{ "schemaVersion": 2, "eyebrow": "Gynecologic Oncology", "title": "Vulvar Cancer", "summary": "Manage vulvar cancer through biopsy-confirmed histology, clinically directed groin assessment, imaging for suspected nodal or advanced disease, and individualized primary excision with inguinofemoral staging. Sentinel-node techniques can reduce long-term morbidity in appropriately selected early-stage disease.", "seoDescription": "Physician guide to vulvar cancer diagnosis, imaging, surgery, sentinel-node staging, pathology interpretation, and management of advanced or recurrent disease.", "clinicalQuestion": "How should physicians diagnose, stage, and select local and groin treatment for vulvar cancer?", "specialty": "Gynecologic Oncology", "audience": "U.S. physicians and medical trainees", "tags": [ "vulvar squamous cell carcinoma", "vulvar cancer staging", "sentinel lymph node biopsy", "inguinofemoral lymphadenectomy", "vulvar biopsy", "vulvar cancer surgery" ], "keyTakeaways": [ "Obtain tissue diagnosis from a suspicious vulvar lesion before definitive treatment; vulvar biopsy remains the histologic standard for invasive carcinoma. [12]", "Primary management of vulvar squamous cell carcinoma is surgical tumor resection with assessment of inguinofemoral nodes when indicated. [4][15]", "For early-stage disease in which sentinel-node assessment is used, technetium-99m mapping with blue dye and pathologic ultrastaging is associated with less morbidity than inguinofemoral lymphadenectomy, but a false-negative sentinel node can lead to potentially lethal groin recurrence. [9]", "Use MRI, CT, or PET when anatomic extent or nodal/distant spread requires clarification for treatment planning. [13][24]", "Pathology may use diffuse strong p16 staining as a surrogate for high-risk HPV-associated disease; focal or weak p16 positivity is nonspecific. [12]" ], "sections": [ { "id": "initial-diagnostic-pathway", "eyebrow": "Diagnosis", "heading": "Confirm invasion and define the anatomic problem", "intro": "Biopsy drives treatment selection; imaging refines extent when examination alone cannot define management.", "paragraphs": [ "Biopsy any clinically concerning raised vulvar lesion before ablative or definitive surgical therapy when invasive carcinoma is possible. Visual assessment identifies the target, but histologic interpretation remains the diagnostic standard for invasive disease. [12]", "After carcinoma is confirmed, document lesion location, local extension, and bilateral groin examination because vulvar squamous cell carcinoma is primarily managed by resection of the primary tumor plus inguinofemoral nodal staging when appropriate. [4][15] Obtain MRI, CT, or PET when the local extent, regional nodal status, or more distant disease would alter operative planning or favor multimodality treatment. [13][24]", "Use pathology to distinguish HPV-associated biology from non-HPV-associated pathways when this information is clinically or diagnostically relevant. Diffuse, intense nuclear and cytoplasmic p16 staining correlates with high-risk HPV infection, whereas focal or weak p16 staining should not be interpreted as specific evidence of HPV-driven disease. [12]" ], "bullets": [ "Do not treat a suspicious lesion as vulvar intraepithelial neoplasia without biopsy when invasion remains in the differential. [12]", "Select cross-sectional imaging according to the unanswered management question: MRI for local anatomic definition and CT or PET for assessment of nodal or distant spread. [13][24]", "Refer patients with biopsy-proven invasive disease for gynecologic-oncology surgical planning because groin staging and primary resection are central components of management. [4][15]" ], "subsections": [], "table": { "caption": "Diagnostic actions that change initial vulvar cancer management. [12][13][24]", "columns": [ "Clinical decision", "Action", "Interpretation and next step" ], "rows": [ [ "Suspicious raised vulvar lesion", "Perform vulvar biopsy. [12]", "Histology confirms or excludes invasive carcinoma before definitive treatment. [12]" ], [ "Need to characterize local tumor extent", "Obtain pelvic MRI. [13][24]", "Use anatomic findings to plan local resection and assess potential adjacent-structure involvement. [13][24]" ], [ "Concern for nodal or distant disease", "Obtain CT or PET. [13][24]", "Use results to determine whether surgery alone remains appropriate or multimodality planning is needed. [13][24]" ], [ "HPV-associated pathway is diagnostically relevant", "Interpret p16 immunohistochemistry in context. [12]", "Diffuse strong nuclear and cytoplasmic staining supports high-risk HPV association; weak or focal staining is nonspecific. [12]" ] ] } }, { "id": "primary-tumor-treatment", "eyebrow": "Local Therapy", "heading": "Use surgery as the primary treatment modality", "intro": "The operative objective is complete primary-tumor resection while preserving function whenever feasible.", "paragraphs": [ "Surgery is the primary treatment modality for vulvar cancer and generally includes resection of the primary tumor with inguinofemoral nodal staging. [4][15] The operative plan should be based on biopsy-proven histology and mapped tumor extent rather than visual estimation alone; imaging becomes particularly useful when deep, adjacent-organ, or nodal involvement may alter the operation. [13][24]", "For vulvar high-grade squamous intraepithelial lesion rather than invasive carcinoma, simple excision with 5-mm margins and 4-mm depth is described as the most common approach. [21] Do not extrapolate this HSIL excision specification to an invasive tumor without an invasive-cancer operative plan, because invasive vulvar carcinoma requires primary resection and consideration of inguinofemoral staging. [4][15][21]", "When primary surgery cannot reliably address locoregional disease, multidisciplinary planning should integrate the anatomic findings from MRI, CT, or PET with the anticipated morbidity of resection and nodal treatment. [13][24] Radical local resection and inguinal node excision are established components of treatment, with chemotherapy and radiation used in selected circumstances. [4]" ], "bullets": [ "Base the resection plan on histology, lesion location, and imaging-defined extension. [12][13][24]", "Include groin management in the initial operative decision; omission of nodal evaluation can leave regional disease untreated. [4][15]", "Use multidisciplinary review when imaging suggests disease for which surgical morbidity or feasibility is uncertain. [13][24]" ], "subsections": [], "table": { "caption": "Local-treatment branch points in vulvar neoplasia. [4][15][21]", "columns": [ "Pathologic category", "Treatment focus", "Key operative distinction" ], "rows": [ [ "Vulvar HSIL", "Simple excision is commonly performed with 5-mm margins and 4-mm depth. [21]", "This approach addresses preinvasive disease and should not substitute for invasive-cancer staging. [21]" ], [ "Invasive vulvar squamous cell carcinoma", "Resect the primary tumor and plan inguinofemoral nodal staging. [4][15]", "Management requires a primary-tumor and groin strategy. [4][15]" ], [ "Disease with concerning local or nodal extension", "Use MRI, CT, or PET to guide a surgical versus multimodality plan. [13][24]", "Imaging-defined extent may change resectability and the anticipated morbidity of local and nodal treatment. [13][24]" ] ] } }, { "id": "groin-staging", "eyebrow": "Regional Nodes", "heading": "Select sentinel-node staging versus inguinofemoral lymphadenectomy", "intro": "Groin management balances occult nodal risk against the substantial long-term morbidity of lymphadenectomy.", "paragraphs": [ "Inguinofemoral nodal staging is integral to the surgical management of invasive vulvar cancer. [4][15] In selected early-stage settings, sentinel lymph node biopsy provides a less morbid alternative to full inguinofemoral lymphadenectomy, but it must be performed with rigorous mapping and pathology because false-negative sentinel nodes can present as groin recurrence with a higher risk of mortality. [9]", "A sentinel-node strategy using technetium-99m and blue dye with hematoxylin-and-eosin histopathology, followed by ultrastaging and immunohistochemistry for initially negative nodes, was modeled as an effective approach for two-year survival free of morbidity. [9] The same analysis identified technetium-99m mapping with ultrastaging after negative H&E assessment as the most cost-effective strategy for survival free of long-term morbidity over two years. [9]", "Counsel patients that lymphedema is a clinically meaningful long-term tradeoff of inguinofemoral lymphadenectomy; it has greater quality-of-life impact than sentinel-node biopsy in comparative analyses. [9] Conversely, a negative sentinel-node result does not eliminate the need for surveillance, because false-negative mapping may be followed by groin recurrence within the two-year period used in the analysis. [9]" ], "bullets": [ "Use a systematic sentinel-node protocol when choosing nodal mapping; incomplete mapping or inadequate pathology undermines the morbidity benefit of avoiding full lymphadenectomy. [9]", "Discuss the competing risks explicitly: reduced long-term morbidity with sentinel-node staging versus the consequences of false-negative groin staging. [9]", "Maintain focused groin surveillance after sentinel-node biopsy, particularly during the first two years. [9]" ], "subsections": [], "table": { "caption": "Tradeoffs between sentinel-node biopsy and inguinofemoral lymphadenectomy in early-stage vulvar cancer. [9]", "columns": [ "Strategy", "Technique or consequence", "Decision-relevant tradeoff" ], "rows": [ [ "Sentinel lymph node biopsy", "Technetium-99m plus blue dye; H&E assessment with ultrastaging and immunohistochemistry after negative H&E. [9]", "Associated with better morbidity-related outcomes than inguinofemoral lymphadenectomy in the modeled two-year analysis. [9]" ], [ "Inguinofemoral lymphadenectomy", "Full regional nodal dissection. [4][15]", "Carries greater long-term edema-related morbidity than sentinel-node biopsy. [9]" ], [ "False-negative sentinel-node result", "Regional disease can later present as groin recurrence. [9]", "Groin recurrence carries higher mortality risk; surveillance remains necessary. [9]" ] ] } }, { "id": "advanced-recurrent-disease", "eyebrow": "Escalation", "heading": "Escalate anatomically advanced or recurrent disease with multidisciplinary planning", "intro": "Extent of disease, not molecular testing alone, should determine the first escalation step.", "paragraphs": [ "For disease in which examination raises concern for extensive local spread, bulky nodal disease, or distant metastasis, obtain MRI, CT, or PET before committing to definitive surgery. [13][24] These modalities are used to determine disease extent and should be incorporated into treatment planning when the procedure required for complete resection may be extensive. [13][24]", "Vulvar squamous cell carcinoma treatment may include radical resection of the primary tumor, excision of inguinal lymph nodes, and, in some circumstances, chemotherapy or radiation. [4] Use multidisciplinary gynecologic-oncology, radiation-oncology, pathology, and radiology review when imaging or operative findings suggest that local control will require combined-modality treatment. [4][13][24]", "Do not assume that a molecular alteration predicts meaningful benefit from a genome-targeted therapy in advanced cancer. Across NCCN-recommended genome-targeted therapies for metastatic cancers, only about one eighth were classified as having a high likelihood of benefit and approximately one third as promising but unproven by ESMO frameworks. [7] If considering biomarker-directed or immune therapy in advanced vulvar cancer, interpret biomarkers in the context of tumor type, treatment setting, and established drug-specific evidence rather than using broad gynecologic-cancer biomarker associations alone. [8]" ], "bullets": [ "Obtain cross-sectional imaging before a potentially morbid operation when local, nodal, or distant extent is uncertain. [13][24]", "Use combined-modality discussion when complete surgical control is doubtful or would require extensive resection. [4][13][24]", "Treat broad molecular targetability as hypothesis-generating unless a tumor-specific, treatment-specific indication supports action. [7][8]" ], "subsections": [], "table": { "caption": "Escalation triggers for advanced or recurrent vulvar cancer. [4][13][24]", "columns": [ "Clinical scenario", "Immediate next step", "Purpose" ], "rows": [ [ "Uncertain deep local extent", "MRI. [13][24]", "Define local anatomy for resection or combined-modality planning. [13][24]" ], [ "Suspicious regional nodes or possible distant disease", "CT or PET. [13][24]", "Assess nodal and distant extent before selecting definitive treatment. [13][24]" ], [ "Potentially extensive locoregional treatment requirement", "Multidisciplinary review of surgery, radiation, and systemic therapy options. [4][13][24]", "Match local-control strategy to resectability and anticipated treatment morbidity. [4][13][24]" ] ] } }, { "id": "surveillance-and-risk", "eyebrow": "Follow-up", "heading": "Prioritize groin examination and prompt biopsy of new lesions", "intro": "Post-treatment surveillance is directed at local and groin recurrence rather than routine molecular testing.", "paragraphs": [ "After surgical treatment, perform focused vulvar and groin examination at follow-up visits and promptly biopsy a new or suspicious lesion rather than relying on visual impression alone. [12] This is particularly important after sentinel-node staging because false-negative nodal assessment can lead to groin recurrence, and the two-year horizon has been used because such recurrences would be expected to declare themselves within that interval. [9]", "When surveillance identifies a suspicious groin finding or a lesion whose local extent cannot be reliably assessed clinically, use MRI, CT, or PET to restage anatomy before salvage planning. [13][24] The decision should then return to the same core branches: feasibility of local resection, requirement for regional nodal management, and need for radiation or chemotherapy as part of a multimodality strategy. [4][13][24]", "Interpret survival estimates cautiously at the individual level because stage and age influence outcomes in vulvar cancer. [1] These variables should inform prognostic counseling but should not replace tumor-directed assessment of local extent, regional nodes, and treatment feasibility. [1][13][24]" ], "bullets": [ "Biopsy suspicious vulvar findings during surveillance. [12]", "Examine the groins closely after sentinel-node biopsy, with particular attention during the first two years. [9]", "Restage with MRI, CT, or PET before planning treatment for suspected locoregional or distant recurrence. [13][24]" ], "subsections": [], "table": { "caption": "Surveillance actions after treatment of vulvar cancer. [9][12][13][24]", "columns": [ "Finding", "Action", "Reason" ], "rows": [ [ "New suspicious vulvar lesion", "Perform vulvar biopsy. [12]", "Histology is required to confirm invasive disease or recurrence. [12]" ], [ "New groin abnormality after sentinel-node biopsy", "Prompt groin assessment and cross-sectional imaging when extent is uncertain. [9][13][24]", "False-negative sentinel-node staging may present as groin recurrence with higher mortality risk. [9]" ], [ "Suspected extensive recurrence", "MRI, CT, or PET followed by multidisciplinary treatment planning. [13][24]", "Restaging defines whether salvage surgery, nodal treatment, radiation, chemotherapy, or combined treatment is appropriate. 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Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "Influence of stage and age on survival of patients with ...", "detail": "bmjopen.bmj.com", "url": "https://bmjopen.bmj.com/content/14/8/e077960", "authors": "bmjopen.bmj.com", "host": "bmjopen.bmj.com", "snippet": "by LC Mack · 2024 · Cited by 9 — The mean survival time was 109.8 months (95% CI: 108.7 to 110.9 months) New NCCN Guidelines for Vulvar Cancer. guidelines 2015 for the treatment of vulvar", "score": 0.98592 }, { "number": 2, "title": "ESGO 2019 Book - The Journal for ImmunoTherapy of Cancer", "detail": "jitc.bmj.com", "url": "https://jitc.bmj.com/content/jitc/suppl/2023/08/16/jitc-2023-007336.DC1/jitc-2023-007336supp002_data_supplement.pdf", "authors": "jitc.bmj.com", "host": "jitc.bmj.com", "snippet": "In sub-analyses including only patients with complete para-aortic and pelvic lymphadenectomy and negative lymph nodes (n=404), only LVSI (HR=2.50, CI 1.05-5.98, p=0.039) was associated with a worsened BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reli", "score": 0.9857 }, { "number": 3, "title": "Clinical value of guideline recommended molecular targets and genome targeted cancer therapies: cross sectional study", "detail": "www.bmj.com", "url": "https://www.bmj.com/content/386/bmj-2023-079126", "authors": "www.bmj.com", "host": "www.bmj.com", "snippet": "3. Clinical value of guideline recommended molecular targets and genome targeted cancer therapies: cross sectional study. **Objective** To assess the clinical benefit and actionability of molecular targets for genome targeted cancer drugs recommended for clinical practice by the National Comprehen", "score": 0.97614 }, { "number": 4, "title": "Primary vulvar squamous cell carcinomas with high T ...", "detail": "jitc.bmj.com", "url": "https://jitc.bmj.com/content/9/10/e003671", "authors": "jitc.bmj.com", "host": "jitc.bmj.com", "snippet": "by KE Kortekaas · 2021 · Cited by 27 — VSCC is treated by surgery and includes radical resection of the primary vulvar tumor, excision of inguinal lymph nodes and sometimes (chemo)", "score": 0.97045 }, { "number": 5, "title": "CXCR4/ACKR3/CXCL12 axis in the lymphatic metastasis of ...", "detail": "jcp.bmj.com", "url": "https://jcp.bmj.com/content/75/5/324", "authors": "jcp.bmj.com", "host": "jcp.bmj.com", "snippet": "by N Rusetska · 2022 · Cited by 15 — Vulvar squamous cell carcinoma (VSCC) is a rare disease accounting for about 4% of all gynecological malignancies. VSCC arises via human papilloma virus (HPV)-", "score": 0.96871 }, { "number": 6, "title": "High numbers of activated helper T cells are associated ...", "detail": "jitc.bmj.com", "url": "https://jitc.bmj.com/content/7/1/236", "authors": "jitc.bmj.com", "host": "jitc.bmj.com", "snippet": "by KE Kortekaas · 2019 · Cited by 43 — High numbers of activated helper T cells are associated with better clinical outcome in early stage vulvar cancer, irrespective of HPV or p53", "score": 0.9654 }, { "number": 7, "title": "Clinical value of guideline recommended molecular targets ...", "detail": "www.bmj.com", "url": "https://www.bmj.com/content/386/bmj-2023-079126.full.pdf", "authors": "www.bmj.com", "host": "www.bmj.com", "snippet": "In May 2024 the website MyCancerGenome.org provided a catalog of 18 271 genetic biomarkers and 5519 genome targeted cancer therapies available.5 However, despite the widespread implementation of this technology, the clinical relevance of many genomic alterations is unknown, risking overestimation of", "score": 0.9568 }, { "number": 8, "title": "Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of gynecologic cancer | Journal for ImmunoTherapy of Cancer", "detail": "jitc.bmj.com", "url": "https://jitc.bmj.com/content/11/6/e006624", "authors": "jitc.bmj.com", "host": "jitc.bmj.com", "snippet": "Correction: Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of gynecologic cancer - 26 June 2023. # Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of gynecologic cancer. In addition, ", "score": 0.94998 }, { "number": 9, "title": "Cost-effectiveness of sentinel lymph node biopsy vs inguinofemoral lymphadenectomy in women with vulval cancer | British Journal of Cancer", "detail": "www.nature.com", "url": "https://www.nature.com/articles/bjc2013631", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Title: Cost-effectiveness of sentinel lymph node biopsy vs inguinofemoral lymphadenectomy in women with vulval cancer | British Journal of Cancer\nFor morbidity-free related outcomes for 2 years, sentinel lymph node (SLN) biopsy with 99mTc and blue dye and haematoxylin & eosin (H&E) histopathology, w", "score": 0.7644879 }, { "number": 10, "title": "Surgical margin and other prognostic factors of invasive ...", "detail": "www.cell.com", "url": "https://www.cell.com/heliyon/fulltext/S2405-8440(24)17073-9", "authors": "www.cell.com", "host": "www.cell.com", "snippet": "by B Guo · 2024 · Cited by 1 — Radiotherapy versus inguinofemoral lymphadenectomy as treatment for vulvar cancer patients with micrometastases in the sentinel node:", "score": 0.66959417 }, { "number": 11, "title": "Immunohistochemical and serum profile of squamous cell ...", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0301211526000722", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "by L Della Corte · 2026 · Cited by 1 — Current diagnostic evaluation of vulvar cancer relies on a combination of clinical examination, vulvar biopsy and imaging. Classical markers include p16, a", "score": 0.60386235 }, { "number": 12, "title": "Vulvar Intraepithelial Neoplasia - an overview", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/medicine-and-dentistry/vulvar-intraepithelial-neoplasia", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "p16, a surrogate marker of HPV, can be used to detect HPV infection. Diffuse and intense nuclear and cytoplasmic staining typically correlates with high-risk HPV infection. However, focal and weak positivity should be interpreted with caution, as it is nonspecific. Detection of increased proliferati", "score": 0.46978843 }, { "number": 13, "title": "Surgical management of squamous cell vulvar cancer ...", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S2352578917300152", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "by A Kaban · 2017 · Cited by 12 — imaging techniques, such as magnetic resonance imaging (MRI), computed tomography scan (CT) and positron emission tomography (PET), can be used to determine", "score": 0.3408586 }, { "number": 14, "title": "Stratification of HPV-induced cervical pathology using the ...", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0893395222014065", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "by H Griffin · 2015 · Cited by 94 — Biomarkers for cervical cancer screening: the role of p16(INK4a) to highlight transforming HPV infections. Expert Rev Proteomics, 9 (2012), pp. 149-163.", "score": 0.29443854 }, { "number": 15, "title": "Comprehensive management of vulvovaginal cancers - 2025", "detail": "acsjournals.onlinelibrary.wiley.com", "url": "https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.70014", "authors": "acsjournals.onlinelibrary.wiley.com", "host": "acsjournals.onlinelibrary.wiley.com", "snippet": "by A Nogueira‐Rodrigues · 2025 · Cited by 17 — Surgical intervention remains the primary treatment modality for vulvar cancer, involving tumor resection and inguinofemoral lymph node staging.", "score": 0.6337056 }, { "number": 16, "title": "BGCS—ASM 2025 London Publication of Abstracts", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.18309", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "In cases of primary excision of vulvar cancer, sentinel lymph node biopsy (SLNB) detection rates are high, ranging from 82.7% to 95% when using", "score": 0.59824234 }, { "number": 17, "title": "Prognostic factors and surgical treatment in vulvar carcinoma ...", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/jog.14368", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "Vulvar carcinoma represents 3–5% of all female genital cancers; the main surgical treatment is radical vulvectomy and inguinal lymphadenectomy.", "score": 0.55072874 }, { "number": 18, "title": "Selective Inguinal Lymphadenectomy in the Treatment of ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1155/2011/284374", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Radical wide excision and ipsilateral superficial inguinal lymphadenectomy is performed for lateral T1 or T2 vulvar cancers. All lymph nodes", "score": 0.54346967 }, { "number": 19, "title": "Plenary Sessions Session 1 — Ovary I", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1525-1438.13.s1.1.x", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Objective: To evaluate patients with vulvar malignancies who had groin recurrence after lymphatic mapping and sentinel lymph node (SLN) biopsy.", "score": 0.43438992 }, { "number": 20, "title": "Repeat sentinel lymph node procedure in vulval carcinoma", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2006.01064.x", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "After the SLN procedure, 59 women with vulval cancer underwent a full inguinofemoral lymph node dissection in order to investigate whether any", "score": 0.43352634 }, { "number": 21, "title": "Cancer of the vulva: 2025 update - Obstetrics and Gynecology", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.70390", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "by AB Olawaiye · 2025 · Cited by 14 — Multiple treatment modalities exist for the management of HSIL, but simple excision with margins of 5 mm and a depth of 4 mm is the most common.", "score": 0.35240287 }, { "number": 22, "title": "Anal cancer: Current standards in care and recent changes in ...", "detail": "acsjournals.onlinelibrary.wiley.com", "url": "https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21259", "authors": "acsjournals.onlinelibrary.wiley.com", "host": "acsjournals.onlinelibrary.wiley.com", "snippet": "If reexcision is not feasible, radiotherapy (RT) with or without 5FU-based chemotherapy to a dose of 60 Gray (Gy) is recommended. For T2 or", "score": 0.20268017 }, { "number": 23, "title": "Human Papillomavirus Disease: Adult and Adolescent OIs | NIH", "detail": "clinicalinfo.hiv.gov", "url": "https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/human", "authors": "clinicalinfo.hiv.gov", "host": "clinicalinfo.hiv.gov", "snippet": "# Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV. HPV infection is the major risk factor for development of cervical cancer,5,21 the fourth most common cancer in women worldwide.22 Nearly all cervical cancers contain oncogenic HPV DNA seque", "score": 0.9843 }, { "number": 24, "title": "Carcinoma of the Vulva | RadioGraphics", "detail": "pubs.rsna.org", "url": "https://pubs.rsna.org/doi/abs/10.1148/rg.250139", "authors": "pubs.rsna.org", "host": "pubs.rsna.org", "snippet": "The authors review the vulvar anatomy, as well as the pathogenesis, routes of spread, and key imaging findings of vulvar malignancy.", "score": 0.98408 } ], "publishedAt": "2026-08-24T17:09:47.022491+00:00", "updatedAt": "2026-08-24T17:09:47.022491+00:00", "readingMinutes": 6, "slug": "vulvar-cancer" }