Page 10 - ESGO - Vulvar cancer - Complete report_fxd2

5.7 Chemoradiation

C Definitive chemoradiation with radiation dose escalation is the treatment of choice in patients with
unresectable disease.

C In advanced stage disease neoadjuvant chemoradiation should be considered in order to avoid
exenterative surgery.

C Radiosensitising chemotherapy, preferably with weekly cisplatin, is recommended.

5.8 Systemic treatment

D Data in vulvar cancer are insufficient to recommend a preferred schedule in a palliative setting.

5.9 Treatment of recurrent disease

Treatment of vulvar recurrence
 Radical local excision is recommended.
 For vulvar recurrence with a depth of invasion > 1 mm and previous sentinel lymph node removal

only, inguinofemoral lymphadenectomy should be performed.
 The indications for postoperative radiotherapy are comparable to those for the treatment of primary

disease.
Treatment of groin recurrence
 Restaging by CT or PET -CT of the thorax/abdomen/pelvis is recommended.
 Preferred treatment is radical excision when possible, followed by postoperative radiation in

radiotherapy naïve patients.
 Based on evidence from other squamous cell cancers such as cervical and anal cancer, the addition of

radiosensitising chemotherapy to postoperative radiotherapy should be considered.
 Definitive chemoradiation when surgical treatment is not possible.
Treatment of distant metastases
 Systemic palliative therapy may be considered in individual patients see systemic treatment).

 VULVAR CANCER - GUIDELINES 
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