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, 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

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27 Scopus citations

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)229-244
Number of pages16
JournalJournal of Lower Genital Tract Disease
Volume26
Issue number3
DOIs
StatePublished - 1 Jul 2022

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