European Society of Gynaecological Oncology Guidelines for the Management of Patients with Vulvar Cancer - Update 2023

. 2023 Jul 03 ; 33 (7) : 1023-1043. [epub] 20230703

Jazyk angličtina Země Anglie, Velká Británie Médium electronic

Typ dokumentu časopisecké články, směrnice pro lékařskou praxi

Perzistentní odkaz   https://www.medvik.cz/link/pmid37369376

BACKGROUND: As part of its mission to improve the quality of care for women with gynecological cancers across Europe, the European Society of Gynaecological Oncology (ESGO) first published in 2017 evidence-based guidelines for the management of patients with vulvar cancer. OBJECTIVE: To update the ESGO guidelines based on the new evidence addressing the management of vulvar cancer and to cover new topics in order to provide comprehensive guidelines on all relevant issues of diagnosis and treatment of vulvar cancer. METHODS: The ESGO Council nominated an international development group comprised of practicing clinicians who provide care to vulvar cancer patients and have demonstrated leadership through their expertize in clinical care and research, national and international engagement and profile as well as dedication to the topics addressed to serve on the expert panel (18 experts across Europe). To ensure that the statements were evidence-based, new data identified from a systematic search were reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the international development group. Prior to publication, the guidelines were reviewed by 206 international practitioners in cancer care delivery and patient representatives. RESULTS: The updated guidelines cover comprehensively diagnosis and referral, staging, pathology, pre-operative investigations, surgical management (local treatment, groin treatment, sentinel lymph node procedure, reconstructive surgery), (chemo)radiotherapy, systemic treatment, treatment of recurrent disease (vulvar, inguinal, pelvic, and distant recurrences), and follow-up. Management algorithms are also defined.

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World Health Organization . GLOBOCAN 2020: estimated cancer incidence, mortality and prevalence worldwide in 2020. 2022. Available: https://gco.iarc.fr/today/online-analysis-table?v=2020&mode=cancer&mode_population=continents&population=900&populations=908&key=asr&sex=2&cancer=39&type=0&statistic=5&prevalence=0&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&group_cancer=1&include_nmsc=0&include_nmsc_other=1#collapse-group-0-0 [Accessed 08 Jun 2022].

Oonk MHM, Planchamp F, Baldwin P, et al. . European Society of Gynaecological Oncology Guidelines for the Management of Patients with Vulvar Cancer. Int J Gynecol Cancer 2017;27:832–7. 10.1097/IGC.0000000000000975 PubMed DOI

Dykewicz CA, Centers for Disease Control and Prevention (U.S.), Infectious Diseases Society of America, et al. . Summary of the guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. Clin Infect Dis 2001;33:139–44. 10.1086/321805 PubMed DOI

Bray F, Laversanne M, Weiderpass E, et al. . Geographic and temporal variations in the incidence of vulvar and vaginal cancers. Int J Cancer 2020;147:2764–71. 10.1002/ijc.33055 PubMed DOI

Muigai J, Jacob L, Dinas K, et al. . Potential delay in the diagnosis of vulvar cancer and associated risk factors in women treated in German gynecological practices. Oncotarget 2018;9:8725–30. 10.18632/oncotarget.23848 PubMed DOI PMC

Zapardiel I, Iacoponi S, Coronado PJ, et al. . Prognostic factors in patients with vulvar cancer: the VULCAN study. Int J Gynecol Cancer 2020;30:1285–91. 10.1136/ijgc-2019-000526 PubMed DOI

Olawaiye AB, Cuello MA, Rogers LJ. Cancer of the vulva: 2021 update. Int J Gynaecol Obstet 2021;155 Suppl 1:7–18. 10.1002/ijgo.13881 PubMed DOI PMC

Brierley JD, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours, 8th ed. 2016. Available: https://www.uicc.org/resources/tnm-classification-malignant-tumours-8th-edition

Matsuo K, Klar M, Nishio S, et al. . Validation of the 2021 FIGO staging schema for advanced vulvar cancer. Int J Gynecol Cancer 2022;32:474–9. 10.1136/ijgc-2021-003168 PubMed DOI

van den Einden LCG, Massuger LFAG, Jonkman JK, et al. . An alternative way to measure the depth of invasion of vulvar squamous cell carcinoma in relation to prognosis. Mod Pathol 2015;28:295–302. 10.1038/modpathol.2014.103 PubMed DOI

Pouwer A-FW, Bult P, Otte I, et al. . Measuring the depth of invasion in vulvar squamous cell carcinoma: interobserver agreement and pitfalls. Histopathology 2019;75:413–20. 10.1111/his.13883 PubMed DOI PMC

Skala SL, Ebott JA, Zhao L, et al. . Predictive value of an alternative strategy for measuring depth and size of stage 1 vulvar squamous cell carcinoma. J Low Genit Tract Dis 2020;24:265–71. 10.1097/LGT.0000000000000544 PubMed DOI

McCluggage WG. Carcinoma of the vulva histopathology reporting guide. In: International Collaboration on Cancer Reporting. Sydney, Australia, 2021.

Heatley MK. Dissection and reporting of the organs of the female genital tract. J Clin Pathol 2008;61:241–57. 10.1136/jcp.2007.051110 PubMed DOI

Hinten F, Molijn A, Eckhardt L, et al. . Vulvar cancer: two pathways with different localization and prognosis. Gynecol Oncol 2018;149:310–7. 10.1016/j.ygyno.2018.03.003 PubMed DOI

Hinten F, van den Einden LCG, Cissen M, et al. . Clitoral involvement of squamous cell carcinoma of the vulva: localization with the worst prognosis. Eur J Surg Oncol 2015;41:592–8. 10.1016/j.ejso.2015.01.002 PubMed DOI

Herrington C, Kim K-R, McCluggage W, et al. . Tumours of the vulva. In: Female genital tumours. WHO Classification of Tumours, 5th ed, vol. 4. Lyon, France: International Agency for Research on Cancer, 2020: 419–49.

Cao H, Wang S, Zhang Z, et al. . Prognostic value of overexpressed P16Ink4A in vulvar cancer: a meta-analysis. PLoS One 2016;11:e0152459. 10.1371/journal.pone.0152459 PubMed DOI PMC

Rakislova N, Clavero O, Alemany L, et al. . Histological characteristics of HPV-associated and-independent squamous cell carcinomas of the vulva: a study of 1,594 cases. Int J Cancer 2017;141:2517–27. 10.1002/ijc.31006 PubMed DOI

Tessier-Cloutier B, Kortekaas KE, Thompson E, et al. . Major P53 immunohistochemical patterns in in situ and invasive squamous cell carcinomas of the vulva and correlation with TP53 mutation status. Mod Pathol 2020;33:1595–605. 10.1038/s41379-020-0524-1 PubMed DOI

Kortekaas KE, Solleveld-Westerink N, Tessier-Cloutier B, et al. . Performance of the pattern-based interpretation of P53 immunohistochemistry as a surrogate for TP53 mutations in vulvar squamous cell carcinoma. Histopathology 2020;77:92–9. 10.1111/his.14109 PubMed DOI PMC

Kortekaas KE, Bastiaannet E, van Doorn HC, et al. . Vulvar cancer subclassification by HPV and P53 status results in three clinically distinct subtypes. Gynecol Oncol 2020;159:649–56. 10.1016/j.ygyno.2020.09.024 PubMed DOI

Julia CJ, Hoang LN. A review of prognostic factors in squamous cell carcinoma of the vulva: evidence from the last decade. Semin Diagn Pathol 2021;38:37–49. 10.1053/j.semdp.2020.09.004 PubMed DOI

Ferrari F, Forte S, Ardighieri L, et al. . Multivariate analysis of prognostic factors in primary squamous cell vulvar cancer: the role of perineural invasion in recurrence and survival. Eur J Surg Oncol 2019;45:2115–9. 10.1016/j.ejso.2019.07.029 PubMed DOI

Holthoff ER, Jeffus SK, Gehlot A, et al. . Perineural invasion is an independent pathologic indicator of recurrence in vulvar squamous cell carcinoma. Am J Surg Pathol 2015;39:1070–4. 10.1097/PAS.0000000000000422 PubMed DOI PMC

Woelber L, Griebel L-F, Eulenburg C, et al. . Role of tumour-free margin distance for loco-regional control in vulvar cancer-a subset analysis of the Arbeitsgemeinschaft Gynakologische Onkologie Care-1 multicenter study. Eur J Cancer 2016;69:180–8. 10.1016/j.ejca.2016.09.038 PubMed DOI

Nooij LS, van der Slot MA, Dekkers OM, et al. . Tumour-free margins in vulvar squamous cell carcinoma: does distance really matter. Eur J Cancer 2016;65:139–49. 10.1016/j.ejca.2016.07.006 PubMed DOI

McAlpine JN, Leung SCY, Cheng A, et al. . Human papillomavirus (HPV)-independent vulvar squamous cell carcinoma has a worse prognosis than HPV-associated disease: a retrospective cohort study. Histopathology 2017;71:238–46. 10.1111/his.13205 PubMed DOI

te Grootenhuis NC, Pouwer AW, de Bock GH, et al. . Margin status revisited in vulvar squamous cell carcinoma. Gynecol Oncol 2019;154:266–75. 10.1016/j.ygyno.2019.05.010 PubMed DOI

Nooij LS, Ter Haar NT, Ruano D, et al. . Genomic characterization of vulvar (pre)cancers identifies distinct molecular subtypes with prognostic significance. Clin Cancer Res 2017;23:6781–9. 10.1158/1078-0432.CCR-17-1302 PubMed DOI

Pahmeyer C, Thangarajah F, Ratiu D, et al. . Preoperative biopsies as predictor for the necessity of inguinal lymph node surgery in squamous cell carcinoma of the vulva-a retrospective tertiary center analysis. J Cancer Res Clin Oncol 2020;146:2709–12. 10.1007/s00432-020-03263-1 PubMed DOI PMC

Nikolić O, Sousa FA e, Cunha TM, et al. . Vulvar cancer staging: guidelines of the European Society of Urogenital Radiology (ESUR). Insights Imaging 2021;12:131. 10.1186/s13244-021-01075-6 PubMed DOI PMC

Pleunis N, Pouwer AW, Ploegmakers MJ, et al. . Low incidence of pulmonary metastases in vulvar cancer patients: limited value of routine chest imaging based on a cohort study. BJOG 2022;129:769–76. 10.1111/1471-0528.16636 PubMed DOI PMC

Pounds R, O’Neill D, Subba K, et al. . The role of preoperative computerized tomography (CT) scan of the pelvis and groin in the management of clinically early staged vulva squamous cell carcinoma. Gynecol Oncol 2020;157:444–9. 10.1016/j.ygyno.2020.01.031 PubMed DOI

Bohlin KS, Bruno A-K, von Knorring C, et al. . Accuracy of computerized tomography in the preoperative evaluation of metastases in primary vulvar cancer - a population-based study. Gynecol Oncol 2021;161:449–53. 10.1016/j.ygyno.2021.02.005 PubMed DOI

Crivellaro C, Guglielmo P, De Ponti E, et al. . 18F-FDG PET/CT in preoperative staging of vulvar cancer patients: is it really effective? Medicine (Baltimore) 2017;96:e7943. 10.1097/MD.0000000000007943 PubMed DOI PMC

Fischerova D, Garganese G, Reina H, et al. . Terms, definitions and measurements to describe sonographic features of lymph nodes: consensus opinion from the Vulvar International Tumor Analysis (VITA) group. Ultrasound Obstet Gynecol 2021;57:861–79. 10.1002/uog.23617 PubMed DOI

Garganese G, Fragomeni SM, Pasciuto T, et al. . Ultrasound morphometric and cytologic preoperative assessment of inguinal lymph-node status in women with vulvar cancer: MorphoNode study. Ultrasound Obstet Gynecol 2020;55:401–10. 10.1002/uog.20378 PubMed DOI

Verri D, Moro F, Fragomeni SM, et al. . The role of ultrasound in the evaluation of inguinal lymph nodes in patients with vulvar cancer: a systematic review and meta-analysis. Cancers 2022;14:3082. 10.3390/cancers14133082 PubMed DOI PMC

Angelico G, Santoro A, Inzani F, et al. . Ultrasound-guided FNA cytology of groin lymph nodes improves the management of squamous cell carcinoma of the vulva: results from a comparative cytohistological study. Cancer Cytopathol 2019;127:514–20. 10.1002/cncy.22154 PubMed DOI

Rufini V, Garganese G, Ieria FP, et al. . Diagnostic performance of preoperative [18F]FDG-PET/CT for lymph node staging in vulvar cancer: a large single-centre study. Eur J Nucl Med Mol Imaging 2021;48:3303–14. 10.1007/s00259-021-05257-8 PubMed DOI PMC

Lakhman Y, Vargas HA, Reinhold C, et al. . ACR Appropriateness Criteria® staging and follow-up of vulvar cancer. J Am Coll Radiol 2021;18:S212–28. 10.1016/j.jacr.2021.02.016 PubMed DOI

Fischerova D, Cibula D, Dundr P, et al. . Ultrasound-guided tru-cut biopsy in the management of advanced abdomino-pelvic tumors. Int J Gynecol Cancer 2008;18:833–7. 10.1111/j.1525-1438.2007.01015.x PubMed DOI

Zikan M, Fischerova D, Pinkavova I, et al. . Ultrasound-guided tru-cut biopsy of abdominal and pelvic tumors in gynecology. Ultrasound Obstet Gynecol 2010;36:767–72. 10.1002/uog.8803 PubMed DOI

Epstein E, Van Calster B, Timmerman D, et al. . Subjective ultrasound assessment, the ADNEX model and ultrasound-guided tru-cut biopsy to differentiate disseminated primary ovarian cancer from metastatic non-ovarian cancer. Ultrasound Obstet Gynecol 2016;47:110–6. 10.1002/uog.14892 PubMed DOI

Arvas M, Kahramanoglu I, Bese T, et al. . The role of pathological margin distance and prognostic factors after primary surgery in squamous cell carcinoma of the vulva. Int J Gynecol Cancer 2018;28:623–31. 10.1097/IGC.0000000000001195 PubMed DOI

Baiocchi G, Mantoan H, de Brot L, et al. . How important is the pathological margin distance in vulvar cancer? Eur J Surg Oncol 2015;41:1653–8. 10.1016/j.ejso.2015.09.024 PubMed DOI

Barlow EL, Jackson M, Hacker NF. The prognostic role of the surgical margins in squamous vulvar cancer: a retrospective Australian study. Cancers (Basel) 2020;12:3375. 10.3390/cancers12113375 PubMed DOI PMC

Micheletti L, Preti M, Cintolesi V, et al. . Prognostic impact of reduced tumor-free margin distance on long-term survival in FIGO stage IB/II vulvar squamous cell carcinoma. J Gynecol Oncol 2018;29. 10.3802/jgo.2018.29.e61 PubMed DOI PMC

Milliken S, May J, Sanderson PA, et al. . Reducing the radicality of surgery for vulvar cancer: are smaller margins safer? Minerva Obstet Gynecol 2021;73:160–5. 10.23736/S2724-606X.20.04743-7 PubMed DOI

Pleunis N, Leermakers MEJ, van der Wurff AA, et al. . Surgical margins in squamous cell carcinoma, different for the vulva? Eur J Surg Oncol 2018;44:1555–61. 10.1016/j.ejso.2018.05.031 PubMed DOI

Raimond E, Delorme C, Ouldamer L, et al. . Surgical treatment of vulvar cancer: impact of tumor-free margin distance on recurrence and survival. A multicentre cohort analysis from the Francogyn study group. Eur J Surg Oncol 2019;45:2109–14. 10.1016/j.ejso.2019.07.005 PubMed DOI

Yang J, Delara R, Ghaith S, et al. . Tumor-free margins and local recurrence in squamous cell carcinoma of the vulva. Gynecol Oncol 2020;158:555–61. 10.1016/j.ygyno.2020.06.503 PubMed DOI

Jain V, Sekhon R, Giri S, et al. . Robotic-assisted video endoscopic lnguinal lymphadenectomy in carcinoma vulva: our experiences and intermediate results. Int J Gynecol Cancer 2017;27:159–65. 10.1097/IGC.0000000000000854 PubMed DOI

Mohammad A, Hunter MI. Robot-assisted sentinel lymph node mapping and inguinal lymph node dissection using near-infrared fluorescence in vulvar cancer. J Minim Invasive Gynecol 2019;26:968–72. 10.1016/j.jmig.2019.04.002 PubMed DOI

Wu Q, Gong Z, Zhao Y, et al. . Video endoscopic inguinal lymphadenectomy via 3-incision lateral approach for vulvar cancers: our preliminary outcome of 37 cases. Int J Gynecol Cancer 2016;26:1706–11. 10.1097/IGC.0000000000000816 PubMed DOI

Zhang M, Chen L, Zhang X, et al. . A comparative study of video endoscopic inguinal lymphadenectomy and conventional open inguinal lymphadenectomy for treating vulvar cancer. Int J Gynecol Cancer 2017;27:1983–9. 10.1097/IGC.0000000000001100 PubMed DOI

Naldini A, Rossitto C, Pacelli F, et al. . The video endoscopy inguinal lymphadenectomy for vulvar cancer: a pilot study. Taiwan J Obstet Gynecol 2017;56:281–5. 10.1016/j.tjog.2017.04.003 PubMed DOI

Le A, Xiong J, Wang Z, et al. . Endoscopy-assisted inguinal lymphadenectomy in vulvar cancer. Arch Gynecol Obstet 2018;297:1277–83. 10.1007/s00404-018-4732-6 PubMed DOI

Nabavizadeh R, Petrinec B, Nabavizadeh B, et al. . Inguinal lymph node dissection in the era of minimally invasive surgical technology. Urol Oncol 2023;41:1–14. 10.1016/j.urolonc.2020.07.026 PubMed DOI

Ding J, Teng P, Guan X, et al. . Analysis of short-term efficacy of gasless single-port laparoscopic inguinal lymphadenectomy through vulva incision for vulvar cancer. Front Surg 2022;9. 10.3389/fsurg.2022.813711 PubMed DOI PMC

Di Donato V, Bracchi C, Cigna E, et al. . Vulvo-vaginal reconstruction after radical excision for treatment of vulvar cancer: evaluation of feasibility and morbidity of different surgical techniques. Surg Oncol 2017;26:511–21. 10.1016/j.suronc.2017.10.002 PubMed DOI

Chang TN-J, Lee C-H, Lai C-H, et al. . Profunda artery perforator flap for isolated vulvar defect reconstruction after oncological resection. J Surg Oncol 2016;113:828–34. 10.1002/jso.24233 PubMed DOI

Confalonieri PL, Gilardi R, Rovati LC, et al. . Comparison of V-Y advancement flap versus lotus petal flap for plastic reconstruction after surgery in case of vulvar malignancies: a retrospective single center experience. Ann Plast Surg 2017;79:186–91. 10.1097/SAP.0000000000001094 PubMed DOI

Conri V, Casoli V, Coret M, et al. . Modified gluteal fold V-Y advancement flap for reconstruction after radical vulvectomy. Int J Gynecol Cancer 2016;26:1300–6. 10.1097/IGC.0000000000000765 PubMed DOI

Gentileschi S, Caretto AA, Servillo M, et al. . Feasibility, indications and complications of SCIP flap for reconstruction after extirpative surgery for vulvar cancer. J Plast Reconstr Aesthet Surg 2022;75:1150–7. 10.1016/j.bjps.2021.11.005 PubMed DOI

Gentileschi S, Servillo M, Garganese G, et al. . Surgical therapy of vulvar cancer: how to choose the correct reconstruction J Gynecol Oncol 2016;27:e60. 10.3802/jgo.2016.27.e60 PubMed DOI PMC

Gentileschi S, Servillo M, Garganese G, et al. . Versatility of pedicled anterolateral thigh flap in gynecologic reconstruction after vulvar cancer extirpative surgery. Microsurgery 2017;37:516–24. 10.1002/micr.30077 PubMed DOI

Giannini A, Di Donato V, D’Oria O, et al. . The V-Y gluteal fold advancement flap: outcomes following radical surgery for vulvar malignancies. Int J Gynaecol Obstet 2021;152:421–4. 10.1002/ijgo.13430 PubMed DOI

Lange M, Hage JJ, van Beurden M. A prospective assessment of surgical risk factors in 114 gluteal fold flap reconstructions after oncological vulvoperineal resection. Ann Plast Surg 2017;79:53–9. 10.1097/SAP.0000000000000964 PubMed DOI

Mercut R, Sinna R, Vaucher R, et al. . Triple flap technique for vulvar reconstruction. Ann Chir Plast Esthet 2018;63:343–8. 10.1016/j.anplas.2018.03.007 PubMed DOI

Nomura H, Maeda T, Usami T, et al. . Vulvar reconstruction following surgery for vulvar cancer using a stepladder V-Y advancement medial thigh flap. Int J Gynecol Cancer 2015;25:1484–7. 10.1097/IGC.0000000000000518 PubMed DOI

Selçuk İ, Doğan O, Barut C, et al. . Radical vulvectomy with right gluteal and left medial thigh V-Y advancement flap reconstruction. J Turk Ger Gynecol Assoc 2021;22:339–42. 10.4274/jtgga.galenos.2020.2020.0055 PubMed DOI PMC

Tock S, Wallet J, Belhadia M, et al. . Outcomes of the use of different vulvar flaps for reconstruction during surgery for vulvar cancer. Eur J Surg Oncol 2019;45:1625–31. 10.1016/j.ejso.2019.04.012 PubMed DOI

Hassanzade M, Attaran M, Treglia G, et al. . Lymphatic mapping and sentinel node biopsy in squamous cell carcinoma of the vulva: systematic review and meta-analysis of the literature. Gynecol Oncol 2013;130:237–45. 10.1016/j.ygyno.2013.04.023 PubMed DOI

Lawrie TA, Patel A, Martin-Hirsch PPL, et al. . Sentinel node assessment for diagnosis of groin lymph node involvement in vulval cancer. Cochrane Database Syst Rev 2014;2014:CD010409. 10.1002/14651858.CD010409.pub2 PubMed DOI PMC

Meads C, Sutton A, Małysiak S, et al. . Sentinel lymph node status in vulval cancer: systematic reviews of test accuracy and decision-analytic model-based economic evaluation. Health Technol Assess 2013;17:1–216. 10.3310/hta17600 PubMed DOI PMC

Van der Zee AGJ, Oonk MH, De Hullu JA, et al. . Sentinel node dissection is safe in the treatment of early-stage vulvar cancer. J Clin Oncol 2008;26:884–9. 10.1200/JCO.2007.14.0566 PubMed DOI

Deken MM, van Doorn HC, Verver D, et al. . Near-infrared fluorescence imaging compared to standard sentinel lymph node detection with blue dye in patients with vulvar cancer - a randomized controlled trial. Gynecol Oncol 2020;159:672–80. 10.1016/j.ygyno.2020.09.044 PubMed DOI

Koual M, Benoit L, Nguyen-Xuan H-T, et al. . Diagnostic value of indocyanine green fluorescence guided sentinel lymph node biopsy in vulvar cancer: a systematic review. Gynecol Oncol 2021;161:436–41. 10.1016/j.ygyno.2021.01.031 PubMed DOI

Di Donna MC, Quartuccio N, Giallombardo V, et al. . Detection of sentinel lymph node in vulvar cancer using (99M)Tc-labeled colloid lymphoscintigraphy, blue dye, and indocyanine-green fluorescence: a meta-analysis of studies published in 2010-2020. Arch Gynecol Obstet 2023;307:1677–86. 10.1007/s00404-022-06605-1 PubMed DOI

Prader S, du Bois A, Harter P, et al. . Sentinel lymph node mapping with fluorescent and radioactive tracers in vulvar cancer patients. Arch Gynecol Obstet 2020;301:729–36. 10.1007/s00404-019-05415-2 PubMed DOI

van Doorn HC, van Beekhuizen HJ, Gaarenstroom KN, et al. . Repeat sentinel lymph node procedure in patients with recurrent vulvar squamous cell carcinoma is feasible. Gynecol Oncol 2016;140:415–9. 10.1016/j.ygyno.2016.01.013 PubMed DOI

Swift BE, Tigert M, Nica A, et al. . The accuracy of intraoperative frozen section examination of sentinel lymph nodes in squamous cell cancer of the vulva. Gynecol Oncol 2022;164:393–7. 10.1016/j.ygyno.2021.11.020 PubMed DOI

Oonk MHM, Slomovitz B, Baldwin PJW, et al. . Radiotherapy versus inguinofemoral lymphadenectomy as treatment for vulvar cancer patients with micrometastases in the sentinel node: results of GROINSS-V II. J Clin Oncol 2021;39:3623–32. 10.1200/JCO.21.00006 PubMed DOI PMC

Woelber L, Eulenburg C, Grimm D, et al. . The risk of contralateral non-sentinel metastasis in patients with primary vulvar cancer and unilaterally positive sentinel node. Ann Surg Oncol 2016;23:2508–14. 10.1245/s10434-016-5114-6 PubMed DOI

Nica A, Covens A, Vicus D, et al. . Sentinel lymph nodes in vulvar cancer: management dilemmas in patients with positive nodes and larger tumors. Gynecol Oncol 2019;152:94–100. 10.1016/j.ygyno.2018.10.047 PubMed DOI

Ignatov T, Gaßner J, Bozukova M, et al. . Contralateral lymph node metastases in patients with vulvar cancer and unilateral sentinel lymph node metastases. Acta Obstet Gynecol Scand 2021;100:1520–5. 10.1111/aogs.14157 PubMed DOI

Winarno AS, Mondal A, Martignoni FC, et al. . The potential risk of contralateral non-sentinel groin node metastasis in women with early primary vulvar cancer following unilateral sentinel node metastasis: a single center evaluation in University Hospital of Dusseldorf. BMC Womens Health 2021;21:23. 10.1186/s12905-020-01165-5 PubMed DOI PMC

Van der Kolk WL, Van der Zee AGJ, Slomovitz BM, et al. . Unilateral inguinofemoral lymphadenectomy in patients with early-stage vulvar squamous cell carcinoma and a unilateral metastatic sentinel lymph node is safe. Gynecol Oncol 2022;167:3–10. 10.1016/j.ygyno.2022.07.017 PubMed DOI

Gadducci A, Aletti GD. Locally advanced squamous cell carcinoma of the vulva: a challenging question for gynecologic oncologists. Gynecol Oncol 2020;158:208–17. 10.1016/j.ygyno.2020.05.021 PubMed DOI

Tagliaferri L, Lancellotta V, Casà C, et al. . The radiotherapy role in the multidisciplinary management of locally advanced vulvar cancer: a multidisciplinary VulCan team review. Cancers (Basel) 2021;13:5747. 10.3390/cancers13225747 PubMed DOI PMC

Chapman BV, Gill BS, Viswanathan AN, et al. . Adjuvant radiation therapy for margin-positive vulvar squamous cell carcinoma: defining the ideal dose-response using the National Cancer Data Base. Int J Radiat Oncol Biol Phys 2017;97:107–17. 10.1016/j.ijrobp.2016.09.023 PubMed DOI

Bhatla N, Tomar S, Meena J, et al. . Adjuvant treatment in cervical, vaginal and vulvar cancer. Best Pract Res Clin Obstet Gynaecol 2022;78:36–51. 10.1016/j.bpobgyn.2021.07.005 PubMed DOI

Ignatov T, Eggemann H, Burger E, et al. . Adjuvant radiotherapy for vulvar cancer with close or positive surgical margins. J Cancer Res Clin Oncol 2016;142:489–95. 10.1007/s00432-015-2060-9 PubMed DOI

Lukovic J, Han K. Postoperative management of vulvar cancer. Int J Gynecol Cancer 2022;32:338–43. 10.1136/ijgc-2021-002463 PubMed DOI

Castelnau-Marchand P, Escande A, Mazeron R, et al. . Brachytherapy as part of the conservative treatment for primary and recurrent vulvar carcinoma. Brachytherapy 2017;16:518–25. 10.1016/j.brachy.2017.01.005 PubMed DOI

Woelber L, Prieske K, Eulenburg CZ, et al. . Adjuvant radiotherapy and local recurrence in vulvar cancer - a subset analysis of the AGO-Care-1 study. Gynecol Oncol 2022;164:68–75. 10.1016/j.ygyno.2021.11.004 PubMed DOI

Gill BS, Bernard ME, Lin JF, et al. . Impact of adjuvant chemotherapy with radiation for node-positive vulvar cancer: a National Cancer Data Base (NCDB) analysis. Gynecol Oncol 2015;137:365–72. 10.1016/j.ygyno.2015.03.056 PubMed DOI

Rydzewski NR, Kanis MJ, Donnelly ED, et al. . Role of adjuvant external beam radiotherapy and chemotherapy in one versus two or more node-positive vulvar cancer: a National Cancer Database study. Radiother Oncol 2018;129:534–9. 10.1016/j.radonc.2018.03.023 PubMed DOI

Ashmore S, Crafton SM, Miller EM, et al. . Optimal overall treatment time for adjuvant therapy for women with completely resected, node-positive vulvar cancer. Gynecol Oncol 2021;161:63–9. 10.1016/j.ygyno.2021.01.003 PubMed DOI

Moore DH, Thomas GM, Montana GS, et al. . Preoperative chemoradiation for advanced vulvar cancer: a phase II study of the Gynecologic Oncology Group. Int J Radiat Oncol Biol Phys 1998;42:79–85. 10.1016/s0360-3016(98)00193-x PubMed DOI

Moore DH, Ali S, Koh W-J, et al. . A phase II trial of radiation therapy and weekly cisplatin chemotherapy for the treatment of locally-advanced squamous cell carcinoma of the vulva: a Gynecologic Oncology Group study. Gynecol Oncol 2012;124:529–33. 10.1016/j.ygyno.2011.11.003 PubMed DOI

van Doorn HC, Ansink A, Verhaar-Langereis M, et al. . Neoadjuvant chemoradiation for advanced primary vulvar cancer. Cochrane Database Syst Rev 2006;3:CD003752. 10.1002/14651858.CD003752.pub2 PubMed DOI

Rao YJ, Chin R-I, Hui C, et al. . Improved survival with definitive chemoradiation compared to definitive radiation alone in squamous cell carcinoma of the vulva: a review of the National Cancer Database. Gynecol Oncol 2017;146:572–9. 10.1016/j.ygyno.2017.06.022 PubMed DOI

Richman AH, Vargo JA, Ling DC, et al. . Dose-escalated intensity modulated radiation therapy in patients with locally-advanced vulvar cancer - does it increase response rate? Gynecol Oncol 2020;159:657–62. 10.1016/j.ygyno.2020.09.019 PubMed DOI

Beriwal S, Coon D, Heron DE, et al. . Preoperative intensity-modulated radiotherapy and chemotherapy for locally advanced vulvar carcinoma. Gynecol Oncol 2008;109:291–5. 10.1016/j.ygyno.2007.10.026 PubMed DOI

Rishi A, Rollins M, Ahmed KA, et al. . High-dose intensity-modulated chemoradiotherapy in vulvar squamous cell carcinoma: outcome and toxicity. Gynecol Oncol 2020;156:349–56. 10.1016/j.ygyno.2019.11.027 PubMed DOI

Mahantshetty U, Naga P, Engineer R, et al. . Clinical outcome of high-dose-rate interstitial brachytherapy in vulvar cancer: a single institutional experience. Brachytherapy 2017;16:153–60. 10.1016/j.brachy.2016.10.003 PubMed DOI

van Triest B, Rasing M, van der Velden J, et al. . Phase II study of definitive chemoradiation for locally advanced squamous cell cancer of the vulva: an efficacy study. Gynecol Oncol 2021;163:117–24. 10.1016/j.ygyno.2021.07.020 PubMed DOI

Forner DM, Mallmann P. Neoadjuvant and definitive chemotherapy or chemoradiation for stage III and IV vulvar cancer: a pooled reanalysis. Eur J Obstet Gynecol Reprod Biol 2017;212:115–8. 10.1016/j.ejogrb.2017.03.030 PubMed DOI

Witteveen PO, van der Velden J, Vergote I, et al. . Phase II study on paclitaxel in patients with recurrent, metastatic or locally advanced vulvar cancer not amenable to surgery or radiotherapy: a study of the EORTC-GCG (European Organisation for Research and Treatment of Cancer--Gynaecological Cancer Group). Ann Oncol 2009;20:1511–6. 10.1093/annonc/mdp043 PubMed DOI PMC

Cormio G, Loizzi V, Gissi F, et al. . Cisplatin and vinorelbine chemotherapy in recurrent vulvar carcinoma. Oncology 2009;77:281–4. 10.1159/000259259 PubMed DOI

Han SN, Vergote I, Amant F. Weekly paclitaxel/carboplatin in the treatment of locally advanced, recurrent, or metastatic vulvar cancer. Int J Gynecol Cancer 2012;22:865–8. 10.1097/IGC.0b013e31824b4058 PubMed DOI

Santeufemia DA, Capobianco G, Re GL, et al. . Cisplatin-gemcitabine as palliative chemotherapy in advanced squamous vulvar carcinoma: report of two cases. Eur J Gynaecol Oncol 2012;33:421–2. PubMed

Monk BJ, Sill MW, McMeekin DS, et al. . Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 2009;27:4649–55. 10.1200/JCO.2009.21.8909 PubMed DOI PMC

Kitagawa R, Katsumata N, Shibata T, et al. . Paclitaxel plus carboplatin versus paclitaxel plus cisplatin in metastatic or recurrent cervical cancer: the open-label randomized phase III trial JCOG0505. JCO 2015;33:2129–35. 10.1200/JCO.2014.58.4391 PubMed DOI

Shapira-Frommer R, Mileshkin L, Manzyuk L, et al. . Efficacy and safety of pembrolizumab for patients with previously treated advanced vulvar squamous cell carcinoma: results from the phase 2 KEYNOTE-158 study. Gynecologic Oncology 2022;166:211–8. 10.1016/j.ygyno.2022.01.029 PubMed DOI

Naumann RW, Hollebecque A, Meyer T, et al. . Safety and efficacy of nivolumab monotherapy in recurrent or metastatic cervical, vaginal, or vulvar carcinoma: results from the phase I/II Checkmate 358 trial. J Clin Oncol 2019;37:2825–34. 10.1200/JCO.19.00739 PubMed DOI PMC

Tewari KS, Monk BJ, Vergote I, et al. . Survival with cemiplimab in recurrent cervical cancer. N Engl J Med 2022;386:544–55. 10.1056/NEJMoa2112187 PubMed DOI

Colombo N, Dubot C, Lorusso D, et al. . Pembrolizumab for persistent, recurrent, or metastatic cervical cancer. N Engl J Med 2021;385:1856–67. 10.1056/NEJMoa2112435 PubMed DOI

Tewari KS, Sill MW, Penson RT, et al. . Bevacizumab for advanced cervical cancer: final overall survival and adverse event analysis of a randomised, controlled, open-label, phase 3 trial (Gynecologic Oncology Group 240). Lancet 2017;390:1654–63. 10.1016/S0140-6736(17)31607-0 PubMed DOI PMC

Growdon WB, Boisvert SL, Akhavanfard S, et al. . Decreased survival in EGFR gene amplified vulvar carcinoma. Gynecol Oncol 2008;111:289–97. 10.1016/j.ygyno.2008.07.038 PubMed DOI

Horowitz NS, Olawaiye AB, Borger DR, et al. . Phase II trial of erlotinib in women with squamous cell carcinoma of the vulva. Gynecol Oncol 2012;127:141–6. 10.1016/j.ygyno.2012.06.028 PubMed DOI

Maggino T, Landoni F, Sartori E, et al. . Patterns of recurrence in patients with squamous cell carcinoma of the vulva. A multicenter CTF study. Cancer 2000;89:116–22. 10.1002/1097-0142(20000701)89:1<116::aid-cncr16>3.0.co;2-4 PubMed DOI

Buchanan TR, Zamorano AS, Massad LS, et al. . Risk of cervical and vaginal dysplasia after surgery for vulvar intraepithelial neoplasia or cancer: a 6 year follow-up study. Gynecol Oncol 2019;155:88–92. 10.1016/j.ygyno.2019.07.017 PubMed DOI PMC

Kuroki LM, Frolova AI, Wu N, et al. . Yield of cytology surveillance after high-grade vulvar intraepithelial neoplasia or cancer. J Low Genit Tract Dis 2017;21:193–7. 10.1097/LGT.0000000000000321 PubMed DOI PMC

Oonk MHM, de Hullu JA, Hollema H, et al. . The value of routine follow-up in patients treated for carcinoma of the vulva. Cancer 2003;98:2624–9. 10.1002/cncr.11837 PubMed DOI

Nordin A, Mohammed KA, Naik R, et al. . Does long-term follow-up have a role for node negative squamous carcinoma of the vulva? The Gateshead experience. Eur J Gynaecol 2001;22:36–9. PubMed

Te Grootenhuis NC, van der Zee AGJ, van Doorn HC, et al. . Sentinel nodes in vulvar cancer: long-term follow-up of the Groningen International Study on Sentinel Nodes in Vulvar Cancer (GROINSS-V) I. Gynecol Oncol 2016;140:8–14. 10.1016/j.ygyno.2015.09.077 PubMed DOI

Pouwer AW, Mus R, IntHout J, et al. . The efficacy of ultrasound in the follow up after a negative sentinel lymph node in women with vulvar cancer: a prospective single-centre study. BJOG 2018;125:1461–8. 10.1111/1471-0528.15341 PubMed DOI PMC

Gonzalez Bosquet J, Magrina JF, Gaffey TA, et al. . Long-term survival and disease recurrence in patients with primary squamous cell carcinoma of the vulva. Gynecol Oncol 2005;97:828–33. 10.1016/j.ygyno.2005.03.006 PubMed DOI

Röhrmoser K, Ignatov A, Gerken M, et al. . Risk factors and temporal patterns of recurrences in patients with vulvar cancer: implications for follow-up intervals and duration. J Cancer Res Clin Oncol 2023;149:803–10. 10.1007/s00432-022-03954-x PubMed DOI

Nooij LS, Brand FAM, Gaarenstroom KN, et al. . Risk factors and treatment for recurrent vulvar squamous cell carcinoma. Crit Rev Oncol Hematol 2016;106:1–13. 10.1016/j.critrevonc.2016.07.007 PubMed DOI

Albano D, Bonacina M, Savelli G, et al. . Clinical and prognostic (18)F-FDG PET/CT role in recurrent vulvar cancer: a multicentric experience. Jpn J Radiol 2022;40:66–74. 10.1007/s11604-021-01173-x PubMed DOI PMC

Te Grootenhuis NC, Pouwer A-F, de Bock GH, et al. . Prognostic factors for local recurrence of squamous cell carcinoma of the vulva: a systematic review. Gynecol Oncol 2018;148:622–31. 10.1016/j.ygyno.2017.11.006 PubMed DOI

Prieske K, Haeringer N, Grimm D, et al. . Patterns of distant metastases in vulvar cancer. Gynecol Oncol 2016;142:427–34. 10.1016/j.ygyno.2016.07.009 PubMed DOI

Zhang W, Zeng A, Yang J, et al. . Outcome of vulvar reconstruction in patients with advanced and recurrent vulvar malignancies. BMC Cancer 2015;15:851. 10.1186/s12885-015-1792-x PubMed DOI PMC

Aviki EM, Esselen KM, Barcia SM, et al. . Does plastic surgical consultation improve the outcome of patients undergoing radical vulvectomy for squamous cell carcinoma of the vulva? Gynecol Oncol 2015;137:60–5. 10.1016/j.ygyno.2015.02.001 PubMed DOI

Hannes S, Nijboer JM, Reinisch A, et al. . Abdominoperineal excisions in the treatment regimen for advanced and recurrent vulvar cancers-analysis of a single-centre experience. Indian J Surg 2015;77:1270–4. 10.1007/s12262-015-1273-0 PubMed DOI PMC

de Gregorio N, de Gregorio A, Ebner F, et al. . Pelvic exenteration as ultimate ratio for gynecologic cancers: single-center analyses of 37 cases. Arch Gynecol Obstet 2019;300:161–8. 10.1007/s00404-019-05154-4 PubMed DOI

Forner DM, Lampe B. Exenteration in the treatment of stage III/IV vulvar cancer. Gynecol Oncol 2012;124:87–91. 10.1016/j.ygyno.2011.09.014 PubMed DOI

Westin SN, Rallapalli V, Fellman B, et al. . Overall survival after pelvic exenteration for gynecologic malignancy. Gynecol Oncol 2014;134:546–51. 10.1016/j.ygyno.2014.06.034 PubMed DOI PMC

van Doorn HC, Oonk MHM, Fons G, et al. . Sentinel lymph node procedure in patients with recurrent vulvar squamous cell carcinoma: a proposed protocol for a multicentre observational study. BMC Cancer 2022;22. 10.1186/s12885-022-09543-y PubMed DOI PMC

Zach D, Kannisto P, Stenström Bohlin K, et al. . Can we extend the indication for sentinel node biopsy in vulvar cancer? A nationwide feasibility study from Sweden. Int J Gynecol Cancer 2020;30:402–5. 10.1136/ijgc-2019-000938 PubMed DOI

Woelber L, Eulenburg C, Kosse J, et al. . Predicting the course of disease in recurrent vulvar cancer - a subset analysis of the AGO-Care-1 study. Gynecol Oncol 2019;154:571–6. 10.1016/j.ygyno.2019.07.009 PubMed DOI

Tantipalakorn C, Robertson G, Marsden DE, et al. . Outcome and patterns of recurrence for International Federation of Gynecology and Obstetrics (FIGO) stages I and II squamous cell vulvar cancer. Obstet Gynecol 2009;113:895–901. 10.1097/AOG.0b013e31819b413f PubMed DOI

Woelber L, Eulenburg C, Choschzick M, et al. . Prognostic role of lymph node metastases in vulvar cancer and implications for adjuvant treatment. Int J Gynecol Cancer 2012;22:503–8. 10.1097/IGC.0b013e31823eed4c PubMed DOI

Cormio G, Loizzi V, Carriero C, et al. . Groin recurrence in carcinoma of the vulva: management and outcome. Eur J Cancer Care (Engl) 2010;19:302–7. 10.1111/j.1365-2354.2008.01011.x PubMed DOI

Wagenaar HC, Colombo N, Vergote I, et al. . Bleomycin, methotrexate, and CCNU in locally advanced or recurrent, inoperable, squamous-cell carcinoma of the vulva: an EORTC Gynaecological Cancer Cooperative Group study. Gynecol Oncol 2001;81:348–54. 10.1006/gyno.2001.6180 PubMed DOI

Frey JN, Hampl M, Mueller MD, et al. . Should groin recurrence still be considered as a palliative situation in vulvar cancer patients?: a brief report. Int J Gynecol Cancer 2016;26:575–9. 10.1097/IGC.0000000000000637 PubMed DOI

Woolderink JM, de Bock GH, de Hullu JA, et al. . Patterns and frequency of recurrences of squamous cell carcinoma of the vulva. Gynecol Oncol 2006;103:293–9. 10.1016/j.ygyno.2006.03.010 PubMed DOI

Ott PA, Bang Y-J, Piha-Paul SA, et al. . T-cell-inflamed gene-expression profile, programmed death ligand 1 expression, and tumor mutational burden predict efficacy in patients treated with pembrolizumab across 20 cancers: KEYNOTE-028. J Clin Oncol 2019;37:318–27. 10.1200/JCO.2018.78.2276 PubMed DOI

Malandrone F, Bevilacqua F, Merola M, et al. . The impact of vulvar cancer on psychosocial and sexual functioning: a literature review. Cancers (Basel) 2021;14:63. 10.3390/cancers14010063 PubMed DOI PMC

Huang J, Yu N, Wang X, et al. . Incidence of lower limb lymphedema after vulvar cancer: a systematic review and meta-analysis. Medicine (Baltimore) 2017;96:e8722. 10.1097/MD.0000000000008722 PubMed DOI PMC

Berger J, Scott E, Sukumvanich P, et al. . The effect of groin treatment modality and sequence on clinically significant chronic lymphedema in patients with vulvar carcinoma. Int J Gynecol Cancer 2015;25:119–24. 10.1097/IGC.0000000000000311 PubMed DOI

Carter J, Huang HQ, Armer J, et al. . GOG 244 - The Lymphedema and Gynecologic cancer (LeG) study: the impact of lower-extremity lymphedema on quality of life, psychological adjustment, physical disability, and function. Gynecol Oncol 2021;160:244–51. 10.1016/j.ygyno.2020.10.023 PubMed DOI PMC

Sharkey AR, King SW, Ramsden AJ, et al. . Do surgical interventions for limb lymphoedema reduce cellulitis attack frequency. Microsurgery 2017;37:348–53. 10.1002/micr.30115 PubMed DOI

Woelber L, Trillsch F, Kock L, et al. . Management of patients with vulvar cancer: a perspective review according to tumour stage. Ther Adv Med Oncol 2013;5:183–92. 10.1177/1758834012471699 PubMed DOI PMC

Crosbie EJ, Slade RJ, Ahmed AS. The management of vulval cancer. Cancer Treat Rev 2009;35:533–9. 10.1016/j.ctrv.2009.01.005 PubMed DOI

Weinberg D, Gomez-Martinez RA. Vulvar cancer. Obstet Gynecol Clin North Am 2019;46:125–35. 10.1016/j.ogc.2018.09.008 PubMed DOI

Smith TJ, Temin S, Alesi ER, et al. . American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol 2012;30:880–7. 10.1200/JCO.2011.38.5161 PubMed DOI

Ferrell BR, Temel JS, Temin S, et al. . Integration of palliative care into standard oncology care: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2017;35:96–112. 10.1200/JCO.2016.70.1474 PubMed DOI

World Health Organization, Worldwide Palliative Care Alliance . Global Atlas of Palliative Care at the End of Life. 2014. Available: https://www.iccp-portal.org/system/files/resources/Global_Atlas_of_Palliative_Care.pdf

Landrum LM, Blank S, Chen L, et al. . Comprehensive care in gynecologic oncology: the importance of palliative care. Gynecol Oncol 2015;137:193–202. 10.1016/j.ygyno.2015.02.026 PubMed DOI

Temel JS, Greer JA, Muzikansky A, et al. . Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733–42. 10.1056/NEJMoa1000678 PubMed DOI

Lefkowits C, Binstock AB, Courtney-Brooks M, et al. . Predictors of palliative care consultation on an inpatient gynecologic oncology service: are we following ASCO recommendations? Gynecol Oncol 2014;133:319–25. 10.1016/j.ygyno.2014.02.031 PubMed DOI

Lefkowits C, Teuteberg W, Courtney-Brooks M, et al. . Improvement in symptom burden within one day after palliative care consultation in a cohort of gynecologic oncology inpatients. Gynecol Oncol 2015;136:424–8. 10.1016/j.ygyno.2014.12.030 PubMed DOI

Nitecki R, Diver EJ, Kamdar MM, et al. . Patterns of palliative care referral in ovarian cancer: a single institution 5 year retrospective analysis. Gynecol Oncol 2018;148:521–6. 10.1016/j.ygyno.2018.01.018 PubMed DOI

Wright AA, Zhang B, Ray A, et al. . Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA 2008;300:1665–73. 10.1001/jama.300.14.1665 PubMed DOI PMC

Bercow AS, Nitecki R, Haber H, et al. . Palliative care referral patterns and measures of aggressive care at the end of life in patients with cervical cancer. Int J Gynecol Cancer 2021;31:66–72. 10.1136/ijgc-2020-001812 PubMed DOI

Doubova SV, Pérez-Cuevas R. Association of supportive care needs and quality of patient-centered cancer care with depression in women with breast and cervical cancer in Mexico. Psychooncology 2021;30:591–601. 10.1002/pon.5608 PubMed DOI

Hoppenot C, Littell RD, DeEulis T, et al. . Top ten tips palliative care clinicians should know about caring for patients with cervical cancer. J Palliat Med 2021;24:438–42. 10.1089/jpm.2021.0006 PubMed DOI

Kim YJ, Munsell MF, Park JC, et al. . Retrospective review of symptoms and palliative care interventions in women with advanced cervical cancer. Gynecol Oncol 2015;139:553–8. 10.1016/j.ygyno.2015.09.079 PubMed DOI PMC

Aeckerle S, Moor M, Pilz LR, et al. . Characteristics, treatment and prognostic factors of patients with gynaecological malignancies treated in a palliative care unit at a university hospital. Oncol Res Treat 2013;36:642–8. 10.1159/000355642 PubMed DOI

Paulsen T, Liland H, Myklebust TÅ, et al. . Early referral to a palliative team improves end-of-life care among gynecological cancer patients: a retrospective, population-based study. Int J Gynecol Cancer 2022;32:181–8. 10.1136/ijgc-2021-002898 PubMed DOI

Sompratthana T, Phoolcharoen N, Schmeler KM, et al. . End-of-life symptoms and interventions among women with gynecologic cancers in a tertiary-care hospital in Thailand. Int J Gynecol Cancer 2019:ijgc-2019-000338. 10.1136/ijgc-2019-000338 PubMed DOI

Krakauer EL, Kwete X, Kane K, et al. . Cervical cancer-associated suffering: estimating the palliative care needs of a highly vulnerable population. JCO Glob Oncol 2021;Oncol7:862–72. 10.1200/GO.21.00025 PubMed DOI PMC

Atreya S. Referral patterns of gynecological cancer patients to a palliative medicine unit: a 2 years retrospective analysis. Indian J Palliat Care 2017;23:409–12. 10.4103/IJPC.IJPC_77_17 PubMed DOI PMC

Maguire R, Kotronoulas G, Simpson M, et al. . A systematic review of the supportive care needs of women living with and beyond cervical cancer. Gynecol Oncol 2015;136:478–90. 10.1016/j.ygyno.2014.10.030 PubMed DOI

Krakauer EL, Kane K, Kwete X, et al. . Augmented package of palliative care for women with cervical cancer: responding to refractory suffering. JCO Glob Oncol 2021;7:886–95. 10.1200/GO.21.00027 PubMed DOI PMC

Krakauer EL, Kane K, Kwete X, et al. . Essential package of palliative care for women with cervical cancer: responding to the suffering of a highly vulnerable population. JCO Glob Oncol 2021;7:873–85. 10.1200/GO.21.00026 PubMed DOI PMC

van Lonkhuijzen L, Thomas G. Palliative radiotherapy for cervical carcinoma, a systematic review. Radiother Oncol 2011;98:287–91. 10.1016/j.radonc.2011.01.009 PubMed DOI

Kim DH, Lee JH, Ki YK, et al. . Short-course palliative radiotherapy for uterine cervical cancer. Radiat Oncol J 2013;31:216. 10.3857/roj.2013.31.4.216 PubMed DOI PMC

Hata M. Radiation therapy for patients with bone metastasis from uterine cervical cancer: its role and optimal radiation regimen for palliative care. Anticancer Res 2018;38:1033–40. 10.21873/anticanres.12319 PubMed DOI

George R, Rai B. Practical aspects of palliative care & palliative radiotherapy in incurable cervical cancer. Indian J Med Res 2021;154:262–6. 10.4103/ijmr.IJMR_1642_20 PubMed DOI PMC

Perrone AM, Cima S, Pozzati F, et al. . Palliative electro-chemotherapy in elderly patients with vulvar cancer: a phase II trial. J Surg Oncol 2015;112:529–32. 10.1002/jso.24036 PubMed DOI

Corrado G, Cutillo G, Fragomeni SM, et al. . Palliative electrochemotherapy in primary or recurrent vulvar cancer. Int J Gynecol Cancer 2020;30:927–31. 10.1136/ijgc-2019-001178 PubMed DOI

Tranoulis A, Georgiou D, Founta C, et al. . Use of electrochemotherapy in women with vulvar cancer to improve quality-of-life in the palliative setting: a meta-analysis. Int J Gynecol Cancer 2020;30:107–14. 10.1136/ijgc-2019-000868 PubMed DOI

Perrone AM, Ravegnini G, Miglietta S, et al. . Electrochemotherapy in vulvar cancer and cisplatin combined with electroporation. Cancers 2021;13:1993. 10.3390/cancers13091993 PubMed DOI PMC

Perrone AM, Ferioli M, Argnani L, et al. . Quality of life with vulvar carcinoma treated with palliative electrochemotherapy: the ELECHTRA (ELEctroCHemoTherapy vulvaR cAncer) study. Cancers (Basel) 2021;13:1622. 10.3390/cancers13071622 PubMed DOI PMC

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