title: Diagnosis and treatment options of vulvar cancer: a review.
abstract: BACKGROUND
  Vulvar cancer is a rare malignancy in women. However, within the past decade, a distinct increase in the incidence of vulvar intraepithelial neoplasia (VIN) as a precursor lesion, and an increase of vulvar cancer have been reported within Europe and the USA. Surgery is the first choice in treating patients with vulvar cancer, especially in its early stages. In an attempt to decrease the incidence of complications, research was made into modifications of the surgical procedure without compromising the prognosis. The replacement of radical vulvectomy by less wide local excision is one of these modifications. As vulvar cancer is relatively rare, it is possible to give evidence-based treatment recommendations, but usually on a low evidence level. Aim of this paper is to elucidate diagnostics and surgical treatment options in the management of vulvar cancer.
  
  
  METHODS
  We searched major databases (i.e. pubmed) with the following selection criteria: vulvar cancer, en bloc resection, triple incision, and sentinel node biopsy.
  
  
  CONCLUSIONS
  Today, the operative therapy is much less radical and more emphasized on individualized therapeutic concepts. The tendency is to leave the ultraradical surgical options which suffer from high morbidity towards less radical, minimal invasive techniques. Due to the rarity of the disease further studies will have to be performed by international collaborative groups.
authors: Department of Obstetrics and Gynaecology, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany. christine.dittmer@uk-sh.de
authors: C
authors: C
authors: Dittmer
authors: D
authors: D
authors: Fischer
authors: K
authors: K
authors: Diedrich
authors: M
authors: M
authors: Thill
mesh_terms: D002278:Carcinoma in Situ / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000628:therapy*