The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD) and the European Federation for Colposcopy (EFC) consensus statements on pre-invasive vulvar lesions

Mario Preti* (Corresponding Author), Elmar Joura, Pedro Vieira-Baptista, Marc Van Beurden, Federica Bevilacqua, Maaike C G Bleeker, Jacob Bornstein, Xavier Carcopino, Cyrus Chargari, Margaret E Cruickshank, Bilal Emre Erzeneoglu, Niccolò Gallio, Debra Heller, Vesna Kesic, Olaf Reich, Colleen K Stockdale, Bilal Esat Temiz, Linn Woelber, François Planchamp, Jana ZodzikaDenis Querleu, Murat Gultekin

*Corresponding author for this work

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Abstract

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) developed consensus statements on pre-invasive vulvar lesions in order to improve the quality of care for patients with vulvar squamous intraepithelial neoplasia, vulvar Paget disease in situ, and melanoma in situ. For differentiated vulvar intraepithelial neoplasia (dVIN), an excisional procedure must always be adopted. For vulvar high-grade squamous intraepithelial lesion (VHSIL), both excisional procedures and ablative ones can be used. The latter can be considered for anatomy and function preservation and must be preceded by several representative biopsies to exclude malignancy. Medical treatment (imiquimod or cidofovir) can be considered for VHSIL. Recent studies favor an approach of using imiquimod in vulvar Paget’s disease. Surgery must take into consideration that the extension of the disease is usually wider than what is evident in the skin. A 2 cm margin is usually considered necessary. A wide local excision with 1 cm free surgical margins is recommended for melanoma in situ. Following treatment of pre-invasive vulvar lesions, women should be seen on a regular basis for careful clinical assessment, including biopsy of any suspicious area. Follow-up should be modulated according to the risk of recurrence (type of lesion, patient age and immunological conditions, other associated lower genital tract lesions).
Original languageEnglish
Pages (from-to)830-845
Number of pages17
JournalInternational Journal of Gynecological Cancer
Volume32
Issue number7
Early online date21 Jun 2022
DOIs
Publication statusPublished - 4 Jul 2022
Event22nd European Gynaecological Oncology Congress of the European Society of Gynaecological Oncology - Prague, Prague, Czech Republic
Duration: 23 Oct 202125 Oct 2022
https://esgo.org/esgo2021/#:~:text=Europe's%20Leading%20Gynaecological%20Oncology%20Gathering,Prague%2C%20Czech%20Republic%20%2B%20Online.

Bibliographical note

Funding
All costs relating to the development process were covered by ESGO, ISSVD, ECSVD, and EFC funds.

Data Availability Statement

Additional supplemental material is published online only. To view, please visit the journal online (http://dx.doi.org/10.1136/ijgc-2021-003262).

Supplemental material
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