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ESTRO/ESGO/SIOPe Guidelines for the management of patients with vaginal cancer
  1. Remi A Nout1,
  2. Gabriele Calaminus2,
  3. François Planchamp3,
  4. Cyrus Chargari4,
  5. Sigurd Lax5,6,
  6. Hélène Martelli7,
  7. W Glenn McCluggage8,
  8. Philippe Morice9,
  9. Maja Pakiz10,
  10. Maximilian P Schmid11,
  11. Jonáh Stunt12,
  12. Beate Timmermann13,14,
  13. Christian Vokuhl15,
  14. Daniel Orbach16 and
  15. Christina Fotopoulou17
  1. 1Radiotherapy, Erasmus MC Cancer Centre, Rotterdam, Please Select, Netherlands
  2. 2Department of Paediatric Hematology and Oncology, University Children’s Hospital, Bonn, Germany
  3. 3Institut Bergonie, Bordeaux, Aquitaine, France
  4. 4Department of Radiation Oncology, Institut Gustave-Roussy, Villejuif, Île-de-France, France
  5. 5Pathology, Hospital Graz Sud-West, Graz, Austria
  6. 6Johannes Kepler Universitat Linz, Linz, Austria
  7. 7Department of Paediatric surgery, Hôpital Universitaire Bicêtre, Paris, France
  8. 8Pathology, Royal Belfast Hospital, Belfast, UK
  9. 9Surgery, Institut Gustave-Roussy, Villejuif, Île-de-France, France
  10. 10Department of Gynecologic Oncology and Breast Oncology, University Medical Centre Maribor, Maribor, Slovenia
  11. 11Department of Obstetrics and Gynecology, Comprehensive Cancer Center Vienna, Wien, Austria
  12. 12Department of Radiotherapy, Erasmus MC Cancer Centre, Rotterdam, Zuid-Holland, Netherlands
  13. 13Department of Particle Therapy, University Hospital Essen, Essen, Nordrhein-Westfalen, Germany
  14. 14West German Proton Therapy Centre, Essen, Germany
  15. 15Department of Pathology, Universitätsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
  16. 16SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, Paris, France
  17. 17Gynaecologic Oncology, Imperial College London Faculty of Medicine, London, London, UK
  1. Correspondence to Dr Remi A Nout, Radiotherapy, Erasmus MC Cancer Centre, Rotterdam, Please Select, Netherlands; r.nout{at}


Primary vaginal malignancies are rare, comprising only 2% of all female genital tract malignancies in adults and 4.5% in children. 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) jointly with the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Pediatric Oncology (SIOPe) developed evidence-based guidelines in order to improve the management of patients with vaginal cancer within a multidisciplinary setting.

ESTRO/ESGO/SIOPe nominated practicing clinicians who are involved in the management of vaginal cancer patients and have demonstrated leadership through their expertise in clinical care and research, their national and international engagement and profile as well as dedication to the topics addressed to serve on the expert panel (13 experts across Europe comprising the international development group). To ensure that the statements were evidence based, the current literature was reviewed and critically appraised.In the case of 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 112 independent international practitionners in cancer care delivery and patient representatives and their comments and input were incorporated and addressed accordingly.

These guidelines cover comprehensively the diagnostic pathways as well as the surgical, radiotherapeutical and systemic management and follow-up of adult patients (including those with rare histological subtypes) and pediatric patients (vaginal rhabdomyosarcoma and germ cell tumours) with vaginal tumours.

  • Vulvar and Vaginal Cancer

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

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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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  • Presented at This paper was jointly developed by European Society for Radiotherapy and Oncology (ESTRO), European Society of Gynaecological Oncology (ESGO) and European Society for Paediatric Oncology (SIOPe), and is jointly published in Radiotherapy and Oncology and International Journal of Gynecological Cancer. The articles are identical except for minor stylistic and spelling differences in keeping with each journal’s style. Either citation can be used when citing this article. Initiated through ESGO the decision to develop multidisciplinary guidelines has been made jointly by the ESGO, ESTRO, and SIOPe. ESGO has provided administrative support. ESGO, ESTRO and ESP are nonprofit knowledgeable societies

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

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests CC has reported advisory boards for GSK and MSD; SL has reported advisory boards for GSK, MSD, Novartis and AstraZeneca;MPS has reported grants and personal fees for workshops from Elekta AB; CF has reported advisory board for Roche, Tesaro, GSK, MDS/AZ, Clovis.

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

  • 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.