This protocol applies to patients with a primary unifocal squamous cell carcinoma of the vulva smaller than 4 cm, with a depth of invasion greater than 1 mm (beyond T1a), and without clinically or radiologically suspicious inguinofemoral lymph nodes. A sentinel lymph node procedure is indicated in this population.
Management in this setting involves a surgical procedure targeting the primary vulvar tumor combined with a lymph node evaluation technique — the specific scope of the nodal procedure is determined by the tumor's anatomical relationship to the midline.
DOI: 10.1136/ijgc-2023-004486
A SLN procedure is indicated in all patients with a primary unifocal tumor <4 cm with a depth of invasion >1 mm and no suspicious nodes.
The SLN procedure is recommended in patients with unifocal cancers of <4 cm, >T1a, without suspicious inguinofemoral nodes [II, B].
Radical local excision is recommended with the aim to obtain histological tumor-free margins [III, B].
For unifocal tumors <4 cm without suspicious inguinofemoral lymph nodes on clinical examination and imaging the SLN procedure is recommended [III, B].
For tumors involving the midline, bilateral SLN detection is mandatory.