Squamous Cell Carcinoma of the Vulva (T1, Depth of Invasion ≤1 mm) — Next Step When Initial Excision Did Not Achieve Clear Margins
Clinical Scenario
This protocol applies to adults with squamous cell carcinoma of the vulva, stage T1, where the depth of invasion is ≤1 mm. At this invasion depth, groin treatment is not required; however, achieving histological tumor-free surgical margins of the vulva remains the critical clinical goal.
Previous Treatment — Goal Not Met
The first-line approach was radical (wide) local excision of the vulvar tumor, with the explicit aim of obtaining histological tumor-free margins. No groin treatment was required at that stage.
This protocol is indicated when that excision did not achieve the target: histological tumor-free surgical margins of the vulvar excision.
Next-Step Treatment Approach (Overview Only)
When invasive disease extends to the excision margins, the preferred next step involves a further surgical intervention when that is feasible. Where surgery cannot be carried out, a different local treatment modality is indicated instead.
The complete treatment algorithm, eligibility criteria, sequencing, and all clinical details are available in the full structured protocol below.
References
DOI: 10.1136/ijgc-2023-004486
- Tumors with depth of invasion ≤1 mm do not need groin treatment.
- These guidelines apply to adults over the age of 18 years with squamous cell carcinoma of the vulva.
- When invasive disease extends to the excision margins of the primary tumor, re-excision is the treatment of choice if feasible [III, A].
- When invasive disease extends to the pathological excision margins of the primary tumor, and further surgical excision is not feasible, post-operative radiotherapy to the vulva is indicated [IV, B].
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