Treatment of Vulvar Cancer with Inguinofemoral and/or Pelvic Lymph Node Recurrence of Squamous Cell Carcinoma
This protocol addresses recurrent squamous cell carcinoma of the vulva presenting as inguinofemoral and/or pelvic lymph node recurrence — a clinically distinct situation that requires specific management depending on the site of nodal relapse and prior treatment history.
Clinical Scenario
Patients present with inguinofemoral and/or pelvic lymph node recurrence of squamous cell carcinoma of the vulva. The approach differs depending on whether recurrence is isolated to the inguinofemoral region, involves pelvic nodes, or occurs in women who have previously received radiotherapy.
Treatment Approach (Overview)
Management integrates surgical and radiotherapy-based strategies, with the specific combination guided by the site of nodal recurrence and prior radiation exposure.
The complete regimen — including sequencing, criteria for each approach, and considerations for previously irradiated patients — is detailed in the full structured protocol.
References
- Preferred treatment of an inguinofemoral nodal recurrence is inguinofemoral lymphadenectomy or debulking of suspicious inguinofemoral lymph nodes, followed by (chemo)radiotherapy in radiotherapy-naive patients [IV, B].
- In case of pelvic lymph node recurrence with or without inguinofemoral lymph node recurrence, (chemo)radiotherapy is recommended [V, B]. Debulking of enlarged pelvic lymph nodes may be considered prior to commencing the treatment [V, C].
- In previously irradiated women, complete resection and/or stereotactic radiotherapy can be considered for oligometastatic inguinofemoral/pelvic disease [V, B]. Systemic therapy may be an option when local therapies are not feasible [V, C].
DOI: 10.1136/ijgc-2023-004486
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