Controversies in the Management of Advanced Vulvar Cancer

  • Ericka Wiebe
  • Jacobus van der Velden
  • Gillian Thomas


Optimal management of advanced vulvar cancer remains one of the most controversial issues within the treatment of gynecologic malignancies. Multimodality therapy that integrates (chemo)radiotherapy with less extensive surgery is well accepted in order to avoid stoma formation; however, the roles for adjuvant therapy after surgical management of both the primary and nodal disease are poorly defined. To avoid exenterative surgery in advanced disease, controversial alternatives including definitive (chemo)radiotherapy and neo-adjuvant chemotherapy have been explored, but are not clearly established. Unfortunately many of these controversies cannot be resolved definitively due to a lack of Level 1 and 2 evidence. Small retrospective series and expert multidisciplinary opinion can guide management in order to obtain the therapeutic advantages of the modalities available and must be tailored to the patient- and tumor-related factors in each situation.


Sentinel Lymph Node Biopsy Adjuvant Radiation Pelvic Exenteration Vulvar Cancer Vulvar Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Ericka Wiebe
    • 1
  • Jacobus van der Velden
    • 2
  • Gillian Thomas
    • 3
  1. 1.Radiation OncologyCross Cancer InstituteEdmontonCanada
  2. 2.Department of Gynecologic OncologyCentre for Gynecologic Oncology Amsterdam (CGOA), Academic Medical CentreAmsterdamThe Netherlands
  3. 3.Radiation Oncology and Obstetrics & GynecologySunnybrook Odette Cancer Centre, University of TorontoTorontoCanada

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