Treatment of Squamous Cell Carcinoma of the Vulva with Tumor ≥4 cm or Multifocal Invasive Disease
This protocol addresses squamous cell carcinoma (SCC) of the vulva in patients presenting with a primary tumor of 4 cm or larger, multifocal invasive disease, or confirmed metastasis to the inguinofemoral (groin) lymph nodes — a setting that calls for systematic lymph node assessment and a structured post-operative treatment plan.
Clinical scenario
Bilateral inguinofemoral lymphadenectomy is indicated when the primary tumor measures ≥4 cm or when multifocal invasive disease is present. In these cases, lymphadenectomy performed via separate incisions is mandatory. Confirmed inguinofemoral node involvement further determines the scope of subsequent treatment.
Treatment approach
Post-operative regional radiotherapy is part of the approach in this setting, with additional concurrent elements considered on the basis of specific surgical and pathological findings.
Full regimen, precise indications, and sequencing are in the structured protocol below.
References
DOI: 10.1136/ijgc-2023-004486
- A bilateral inguinofemoral lymphadenectomy is indicated in patients with tumor ≥4 cm and in multifocal disease.
- For tumors ≥4 cm and/or in case of multifocal invasive disease, inguinofemoral lymphadenectomy by separate incisions is mandatory.
- Radiotherapy is recommended for cases with more than one metastatic lymph node and/or extracapsular spread [II, A].
- Concurrent radiosensitizing chemotherapy should be considered [IV, B].
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