Vulvar Cancer Treatm
The modern treatment of vulvar cancer is less radical,
stage-dependent and based on many individual treatment
concepts. In early stage of vulvar cancers is the locally
surgical tumor removal the treatment of choice. In the
advanced cases, a radical removal of the vulva according
to triple incision technique should be carried out.
Vulvar cancer with an infiltration depth of 1 cm or less
can be treated without inguinal lymph node dissection.
In the absence of clinic suspicious inguinal lymph nodes,
tumor diameter of less than 4 cm and unifocal carcinoma
sentinel lymph node biopsy is a promising technique, but
it is still not yet fully established as a standard therapy.
The pelvic lymphadenectomy with positive inguinal
lymph nodes is controversial. The criteria for adjuvant
radiotherapy of the vulva are still unclear. In general,
irradiation of the vulva is recommended only when
the primary tumor could not be removed completely.
Indications for adjuvant inguinal radiotherapy may be:
when two or more nodes are involved or if a single node
has extracapsular spread or a macrometastasis of more
than 10 mm.
advanced stages of vulvar cancers the neoadjuvante
chemoradiation treatment concept is the first choice.
CME Prakt Fortbild Gynakol Geburtsmed Gynakol
Endokrinol 2013; 9(2): 178–187
Vulvar cancer treatment, triple incision technique, inguinal
lymph node dissection, sentinel lymph node biopsy,
Mustafa Zelal Muallem, Jalid Sehouli
Klinik für Gynäkologie, Charité – Universitätsmedizin Berlin, Berlin
Reviewer: Oumar Camara, Bad Langensalza,
Fabian Trillsch, Hamburg, Uwe Wagner, Marburg,
und Jörg Schwarz, Reinbek
Muallem MZ. Therapie ... Gynakol Geburtsmed Gynakol Endokrinol 2013; 9(2): 178–187 publiziert 31.7.2013 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2013 ISSN 1614-8533