Vulvar Cancer Management and Treatment Strategies

Vulvar cancer, predominantly vulvar squamous cell carcinoma, requires an integrated management approach that balances oncological control with preservation of function and quality of life. Surgery remains the mainstay for early-stage disease, with wide local excision or radical vulvectomy accompanied by lymph node assessment. Molecular stratification based on human papillomavirus (HPV) status and TP53 mutation patterns has refined prognostic groups and guides the intensity of treatment and follow-up surveillance. The adoption of sentinel lymph node biopsy in selected patients has reduced the need for full inguinofemoral lymphadenectomy, diminishing morbidity without compromising outcomes. Radiotherapy and chemoradiation are employed for advanced or recurrent disease, while topical immunomodulators and laser ablation offer non-surgical options for high-grade intraepithelial lesions. Multidisciplinary teams tailor therapy according to tumour stage, location, molecular profile and patient comorbidities. Ongoing advances in targeted agents and immune-based therapies promise further personalization, and emerging clinical guidelines emphasise the importance of long-term surveillance to detect recurrence and manage treatment sequelae.

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Vulvar Cancer Management and Treatment Strategies publication trend

The graph below shows the total number of articles in vulvar cancer management and treatment strategies across all publications each year (not limited to Nature Index journals).

Technical terms

Sentinel lymph node biopsy: A surgical technique that identifies and samples the first draining lymph node(s) from a primary tumour to assess metastatic spread, reducing the need for complete lymphadenectomy.

Inguinofemoral lymphadenectomy: Surgical removal of lymph nodes in the groin (inguinal) and femoral regions to stage or treat vulvar cancer, associated with significant postoperative morbidity.

p16 immunohistochemistry: A staining method detecting p16 protein overexpression as a surrogate marker of oncogenic HPV infection in tumour tissue.

TP53 mutation: Genetic alteration of the TP53 tumour suppressor gene, commonly inferred by aberrant p53 immunostaining, linked to tumour aggressiveness and prognosis.

HPV (human papillomavirus): A family of DNA viruses, certain high-risk types of which drive oncogenesis in vulvar and other anogenital cancers through integration and oncoprotein expression.

References

1. Vulvar cancer subclassification by HPV and p53 status results in three clinically distinct subtypes. Gynecologic Oncology (2020).
2. Sentinel lymph node biopsy in vulval cancer: systematic review and meta-analysis. British Journal of Cancer (2014).
3. Activity, safety, and feasibility of cidofovir and imiquimod for treatment of vulval intraepithelial neoplasia (RT3VIN): a multicentre, open-label, randomised, phase 2 trial. The Lancet Oncology (2014).
4. Risk factors and treatment for recurrent vulvar squamous cell carcinoma. Critical Reviews in Oncology/Hematology (2016).