Page 4 - ESGO - Vulvar cancer - Complete report_fxd2
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1 Introduction

Vulvar cancers are relatively uncommon and affect predominantly elderly women. The vast majority are
squamous cell carcinomas. The objectives of the guidelines are to improve and to homogenize the management
of patients with vulvar cancer. The guideline is intended for use by gynaecological oncologists, general
gynaecologists, surgeons, pathologists, radiotherapists, medical and clinical oncologists, general practitioners,
palliative care teams, and allied health professionals.

The guideline covers diagnosis and referral, preoperative investigations, surgical management local treatment,
groin treatment, reconstructive surgery, sentinel lymph node procedure, ra diation therapy, chemoradiation,
systemic treatment, treatment of recurrent disease vulvar recurrence, groin recurrence, distant metastases, and
follow-up for patients with vulvar cancer and provides information for discussion with patients and carers. This
complete report does not include any economic analysis of the strategies. These guidelines apply to adults over
the age of 18 years with squamous cell carcinoma of the vulva. These guidelines do not address patients with
other vulvar cancer histologies.

Any clinician seeking to apply or consult these guidelines is expected to use independent medical judgment in
the context of individual clinical circumstances to determine any patient’s care or treatment.

2 Acknowledgements

The European society of gynaecological oncology ESGO would like to thank the international development
group for their constant availability, work, and for making possible the development of these guidelines for the
management of patients with vulvar cancer. ESGO also wishes to express sincere gratitude to the Institut
national du cancer INCa, France for providing the main funding for this work.

3 Method

The guidelines were developed using a five-step process see figure 1 . The strengths of the process include
creation of a multidisciplinary international development group, use of scientific evidence and/or international
expert consensus to support the guidelines, use of an international external review process physicians and
patients , and management of potential conflicts of interests. This development process involved two meetings of
the international development group, chaired by Professor Ate van der Zee and Dr Maaike Oonk University
Medical Center Groningen, Netherlands.

                                          Nomination of multidisciplinary international development group

                                                              Identification of scientific evidence

                                                                   Formulation of guidelines

                                                 External evaluation of guidelines international review

                                                     Integration of international reviewers comments

                                                                 Figure 1. Development process

3.1 Nomination of multidisciplinary international development group

The ESGO Council nominated practicing clinicians that care for vulvar cancer patients and have demonstrated
leadership in clinical management of patients through research, administrative responsibilities, and/or committee

                                                                                          VULVAR CANCER - GUIDELINES 
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