Page 48 - ESGO - Vulvar cancer - Complete report_fxd2

15 Follow-up

15.1 Summary of available scientific evidence

No directly applicable clinical studies have been identified.

15.2 Previous initiatives

Six previous initiatives1-3,38,39,271 presenting guidelines on follow-up were identified.

15.3 Development group comments

There is no evidene for best follow-up schedule. Since local recurrences may occur many years after primary
treatment, lifelong follow-up is advised.
Since patients with associated vulvar intraepithelial neoplasia or lichen sclerosus/planus have a higher risk on
local recurrence, more intensive follow-up may be indicated.

15.4 Guidelines

 The optimal follow-up schedule for vulvar cancer is undetermined.
 After primary surgical treatment the following follow-up schedule is suggested:

 First follow-up 6-8 weeks postoperative
 First two years every three-four months
 Third and fourth year biannually
 Afterward, long-term follow-up, especially in case of predisposing vulvar disease.
Follow-up after surgical treatment should include clinical examination of vulva and groins.4
 After definitive (chemo)radiation the following follow-up schedule is suggested:
 First follow-up visit 10-12 weeks post completion of definitive (chemo)radiation.
 First two years every three-four months
 Third and fourth year biannually
 Afterward, long-term follow-up, especially in case of predisposing vulvar disease.
At first follow-up visit 10-12 weeks post definitive (chemo)radiation CT or PET-CT is recommended
to document complete remission.

4 Despite the well-recognized low sensitivity of palpation to identify groin recurrences, currently available data
do not support routine use of imaging of the groins in follow-up.

 VULVAR CANCER - GUIDELINES 
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