J Gynecol Oncol.  2014 Oct;25(4):272-278. 10.3802/jgo.2014.25.4.272.

Defining the concept of locally advanced squamous cell carcinoma of the vulva: a new perspective based on standardization of criteria and current evidence

• Aragona AM
• Soderini A
• Cuneo NA

• KMID: 2130113
• DOI: http://doi.org/10.3802/jgo.2014.25.4.272

Abstract

The phrase "locally advanced carcinoma of the vulva" has often been mentioned in the literature, though not accurately defined, or even leading to the interpretation overlapping. Grounded on cervical cancer experience, we are able to state that designing a tailored primary strategy based on clinically measurable adverse prognostic factors represents the cornerstone of therapy. This fact urged us to rethink about the real usefulness of the concept of locally advanced squamous cell carcinoma of the vulva. We will refer to this concept as a clinical entity emerging from a rigorous workup which is a valuable guiding tool in the context of a thorough debate about the best primary treatment approach to be used. Furthermore, bulky tumors of the vulva have been associated with a worse prognosis on several occasions. Some authors have questioned the fact that tumor size has not been considered in the staging system. Finally, a standardized definition will help us compare the results obtained, which is extremely necessary given the worldwide low prevalence of this disease.

Keyword

Prevalence; Prognosis; Squamous cell carcinoma; Vulva

MeSH Terms

Carcinoma, Squamous Cell/*pathology/therapy
Combined Modality Therapy
Evidence-Based Medicine/methods
Female
Humans
Neoplasm Staging
Prognosis
*Terminology as Topic
Vulvar Neoplasms/*pathology/therapy

Figure

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  Fig. 1 Authors recommendations for the management of probably locally advanced squamous cell carcinoma of the vulva (LASCCV): primary treatment of local disease. DSI, depth of stromal invasion; NCH, neoadjuvant chemotherapy; PE, pelvic exenteration.

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  Fig. 2 Authors recommendations for the management of probably locally advanced squamous cell carcinoma of the vulva (LASCCV): primary treatment of regional disease.

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