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 - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue International Journal of Gynecological Cancer Année : 2022

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

1 Department of Surgical Sciences, University of Torino, Torino, Italy.
2 Medizinische Universität Wien = Medical University of Vienna
3 Hospital Lusiadas Porto, Porto, Portugal; Lower Genital Tract Unit, Centro Hospitalar de São João, Porto, Portugal.
4 Centre for Gynecological Oncology Amsterdam, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
5 Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.
6 MIGAL - Galilee Research Institute [Israël]
7 Service de gynécologie-obstétrique [Hôpital Nord - APHM]
8 IMBE - Institut méditerranéen de biodiversité et d'écologie marine et continentale
9 Département de radiothérapie [Gustave Roussy]
10 Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, UK.
11 Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey.
12 Rutgers New Jersey Medical School, Newark, NJ, USA
13 Department of Obstetrics and Gynecology, University of Belgrade, Belgrade, Serbia.
14 Medical University of Graz
15 Department of Obstetrics & Gynecology, University of Iowa, Iowa City, Iowa, USA.
16 Department of Gynecology, Hamburg-Eppendorf University Medical Center, Dysplasia Center Hamburg, Jerusalem Hospital, Hamburg, Germany.
17 Institut Bergonié [Bordeaux]
18 Department of Obstetrics and Gynaecology Rīga Stradiņš university, Riga, Latvia.
19 Department of Obstetrics and Gynecologic Oncology, University Hospital, Strasbourg, France; Division of Gynecologic Oncology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy.
20 Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Jacob Bornstein

Résumé

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).
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hal-03909756 , version 1 (21-12-2022)

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Mario Preti, Elmar Joura, Pedro Vieira-Baptista, Marc van Beurden, Federica Bevilacqua, et al.. 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. International Journal of Gynecological Cancer, 2022, 32 (7), pp.830-845. ⟨10.1136/ijgc-2021-003262⟩. ⟨hal-03909756⟩
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