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The giant steps in surgical downsizing toward a personalized treatment of vulvar cancer
Author(s) -
Giannini Andrea,
D'Oria Ottavia,
Chiofalo Benito,
Bruno Valentina,
Baiocco Ermelinda,
Mancini Emanuela,
Mancari Rosanna,
Vincenzoni Cristina,
Cutillo Giuseppe,
Vizza Enrico
Publication year - 2022
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.15103
Subject(s) - medicine , vulvar cancer , radical vulvectomy , lymphedema , surgery , groin , vulvar carcinoma , lymphadenectomy , surgical oncology , general surgery , cancer , vulva , breast cancer
The present article aims to highlight the importance of changes of personalized surgical treatment for vulvar cancer. Current international literature regarding surgical treatment of vulvar cancer was evaluated. This included several studies and systematic reviews. Radical surgery approach, such as en bloc resection, was the first therapeutic option and the standard care for many years, even if burdened with a high complication rate and frequently disfiguring. Taussing and Way introduced radical vulvectomy approach with en bloc bilateral inguinal‐femoral lymphadenectomy; modified radical vulvectomy was developed, with a wide radical excision of the primary tumor. The role of inguinofemoral lymphadenectomy (mono or bilateral) changed in the years too, particularly with the advent of SLN biopsy as minimally invasive surgical approach for lymph node staging, in patients with unifocal cancer <4 cm, without suspicious groin nodes. More personalized and conservative surgical approach, consisting of wide local or wide radical excisions, is necessary to reduce complications as lymphedema or sexual disfunction. The optimal surgical management of vulvar cancer needs to consider dimensions, staging, depth of invasion, presence of carcinoma at the surgical margins of resection and grading, with the goal of making the treatment as individualized as possible.