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European Society of Gynaecological Oncology Guidelines for the Management of Patients with Vulvar Cancer - Update 2023
  1. Maaike H M Oonk1,
  2. François Planchamp2,
  3. Peter Baldwin3,
  4. Sven Mahner4,
  5. Mansoor Raza Mirza5,
  6. Daniela Fischerová6,7,
  7. Carien L Creutzberg8,
  8. Eugénie Guillot9,
  9. Giorgia Garganese10,11,
  10. Sigurd Lax12,13,
  11. Andres Redondo14,
  12. Alina Sturdza15,
  13. Alexandra Taylor16,
  14. Elena Ulrikh17,
  15. Vincent Vandecaveye18,
  16. Ate van der Zee1,
  17. Linn Wölber19,
  18. Diana Zach20,21,
  19. Gian Franco Zannoni10,11 and
  20. Ignacio Zapardiel14
  1. 1 University Medical Center Groningen, Groningen, The Netherlands
  2. 2 Institut Bergonie, Bordeaux, France
  3. 3 Addenbrooke's Hospital, Cambridge, UK
  4. 4 University Hospital, Ludwig Maximilians University Munich, Munich, Germany
  5. 5 Rigshospitalet; Copenhagen University Hospital, Copenhagen, Denmark
  6. 6 Charles University First Faculty of Medicine, Prague, Czech Republic
  7. 7 General University Hospital in Prague, Prague, Czech Republic
  8. 8 Leiden University Medical Center, Leiden, The Netherlands
  9. 9 Institut Curie, Paris, France
  10. 10 Catholic University of the Sacred Heart, Rome, Italy
  11. 11 Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  12. 12 Hospital Graz II, Graz, Austria
  13. 13 Johannes Kepler Universitat Linz, Linz, Austria
  14. 14 La Paz University Hospital, Madrid, Spain
  15. 15 University Hospital Vienna, Vienna, Austria
  16. 16 Royal Marsden NHS Foundation Trust, London, UK
  17. 17 Almazov National Medical Research Center, Saint Petersburg, Russian Federation
  18. 18 KU Leuven University Hospitals Leuven, Leuven, Belgium
  19. 19 University Medical Center Hamburg-Eppendorf, Hamburg, Germany
  20. 20 Karolinska University Hospital, Stockholm, Sweden
  21. 21 Karolinska Institutet Eugeniavägen, Stockholm, Sweden
  1. Correspondence to Dr Maaike H M Oonk, University Medical Center Groningen (UMCG), Groningen, 97113GZ, The Netherlands; m.h.m.oonk{at}umcg.nl

Abstract

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.

  • Vulvar and Vaginal Cancer

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/ijgc-2023-004486

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Contributors The development group (including all the authors) is collectively responsible for the decision to submit for publication. MHMO (chair) and François Planchamp (methodologist) wrote the first draft of the manuscript. All the other contributors have actively given personal input, reviewed the manuscript, and have given final approval before submission. MHMO is responsible for the overall content as guarantor.

    • Funding All costs relating to the development process were covered from ESGO funds. There was no external funding of the development process or manuscript production.

    • Competing interests SM has reported advisory boards for AbbVie, AstraZeneca, Clovis, Eisai, GlaxoSmithKline, Hubro, MEdac, MSD, Novartis, Nykode, Novartis, Olympus, PharmaMar, Pfizer, Roche, Sensor Kinesis, Teva, Tesaro, and grants for travelling from AbbVie, AstraZeneca, Clovis, Eisai, GlaxoSmithKline, Hubro, MEdac, MSD, Novartis, Nykode, Olympus, PharmaMar, Pfizer, Roche, Sensor Kinesis, Teva, Tesaro. AR has reported institutional grants from Eisai, PharmaMar, Roche, speaker’s bureau for AstraZeneca, MSD, GlaxoSmithKline, PharmaMar, Clovis, advisory boards for AstraZeneca, Eisai, GlaxoSmithKline, PharmaMar, Clovis, and grants for travelling from AstraZeneca, GlaxoSmithKline, Clovis, and PharmaMar. AS has reported grants for travelling from Elekta, Stiftung Filantropie Österreich, and Medizinische Universität Wien. AT has reported advisory boards for MSD. LW has reported funding from MEdac Oncology, Roche Diagnostics, Hamburger KG, DKH, honoraria from Roche, Tesaro, Pfizer, GlaxoSmithKline, GynOnko Update, AstraZeneca, Teva, Omniamed, Promedicis, MSD, Eisai, Seagen, and advisory boards for MSD, GlaxoSmithKline, Roche, Eisai, and Seagen. MHMO, FP, PB, MRM, DF, CLC, EG, GG, SL, EU, VV, AvdZ, DZ, GFZ, and IZ have reported no conflicts of interest.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Author note The project was initiated by ESGO, which provided administrative and meeting expenses support. The decision to develop guidelines was made by the Guidelines, Recommendations and Quality Assurance Committee of ESGO, with the approval of ESGO Council. ESGO is a nonprofit knowledgeable society.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.