TY - JOUR
T1 - 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
AU - Preti, Mario
AU - Joura, Elmar
AU - Vieira-Baptista, Pedro
AU - Van Beurden, Marc
AU - Bevilacqua, Federica
AU - Bleeker, Maaike C.G.
AU - Bornstein, Jacob
AU - Carcopino, Xavier
AU - Chargari, Cyrus
AU - Cruickshank, Margaret E.
AU - Erzeneoglu, Bilal Emre
AU - Gallio, Niccolò
AU - Heller, Debra
AU - Kesic, Vesna
AU - Reich, Olaf
AU - Stockdale, Colleen K.
AU - Temiz, Bilal Esat
AU - Woelber, Linn
AU - Planchamp, François
AU - Zodzika, Jana
AU - Querleu, Denis
AU - Gultekin, Murat
N1 - Publisher Copyright:
© 2021 ASCCP.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - 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).
AB - 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).
UR - http://www.scopus.com/inward/record.url?scp=85133105847&partnerID=8YFLogxK
U2 - 10.1097/LGT.0000000000000683
DO - 10.1097/LGT.0000000000000683
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C2 - 35763611
AN - SCOPUS:85133105847
SN - 1089-2591
VL - 26
SP - 229
EP - 244
JO - Journal of Lower Genital Tract Disease
JF - Journal of Lower Genital Tract Disease
IS - 3
ER -