This protocol addresses squamous cell carcinoma of the vulva in the presence of at least one of the following: a primary tumour measuring 4 cm or more, multifocal invasive disease, or confirmed metastasis to the inguinofemoral (groin) lymph nodes. These features define a presentation that requires structured management of the regional lymph node basins in addition to local resection.
The surgical strategy centres on radical local excision of the vulvar tumour combined with inguinofemoral lymphadenectomy performed through separate groin incisions, with removal of both superficial and deep femoral nodes. Whether dissection is ipsilateral, bilateral, or extended further depends on tumour laterality and the findings at initial nodal assessment.
The complete nodal selection algorithm, indication criteria, and surgical sequencing are detailed in the full structured protocol.