European Society of Gynaecological Oncology Guidelines for the Management of Patients with Vulvar Cancer - Update 2023

Sep 24, 2026

Evidence-based guidelines published by the European Society of Gynaecological Oncology (ESGO) in 2017 were updated to reflect new evidence for vulvar cancer and to add new topics. The update is based on a systematic search with critical appraisal of new data; when evidence is insufficient, recommendations rely on professional experience and international consensus. Prior publication review involved 206 international cancer care practitioners and patient representatives. The update addresses diagnosis, staging, pathology, investigations, treatment, recurrence management, and follow-up.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages21

Reading Time53 min

AccessFree to download

Abstract

Background

Objective

Methods

Evidence appraisal and consensus

Results

Introduction

Epidemiology and risk factors

Responsibilities

Methods

Five-step guideline development process

Original research For numbered affiliations see end of article. Correspondence to Dr Maaike H M Oonk, University Medical Center Groningen (UMCG), Groningen, 97113GZ, The Netherlands; m. h. m.oonk@ [umcg.nl](umcg.nl) Received 17 March 2023 Accepted 20 April 2023 Published Online First 27 June 2023 © IGCS and ESGO 2023. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ. To cite: Oonk MHM, Planchamp F, Baldwin P, et al. Int J Gynecol Cancer 2023;33:1023–1043 . European Society of Gynaecological Oncology Guidelines for the Management of Patients with Vulvar Cancer-Update 2023 Maaike H M Oonk,1 François Planchamp ,2 Peter Baldwin,3 Sven Mahner,4 Mansoor Raza Mirza,5 Daniela Fischerová ,6,7 Carien L Creutzberg,8 Eugénie Guillot,9 Giorgia Garganese,10,11 Sigurd Lax,12,13 Andres Redondo,14 Alina Sturdza,15 Alexandra Taylor ,16 Elena Ulrikh ,17 Vincent Vandecaveye ,18 Ate van der Zee, Linn Wölber,19 Diana Zach,20,21 Gian Franco Zannoni ,10,11 Ignacio Zapardiel 14 AbStrACt background As part of its mission to improve the quality of care for women with gynecological cancers across Europe, the European Society of Gynaecological Oncology (ESGO) first published in 2017 evidence-based guidelines for the management of patients with vulvar cancer. Objective To update the ESGO guidelines based on the new evidence addressing the management of vulvar cancer and to cover new topics in order to provide comprehensive guidelines on all relevant issues of diagnosis and treatment of vulvar cancer. Methods The ESGO Council nominated an international development group comprised of practicing clinicians who provide care to vulvar cancer patients and have demonstrated leadership through their expertize in clinical care and research, national and international engagement and profile as well as dedication to the topics addressed to serve on the expert panel (18 experts across Europe) . To ensure that the statements were evidence-based, new data identified from a systematic search were reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the international development group. Prior to publication, the guidelines were reviewed by 206 international practitioners in cancer care delivery and patient representatives. results The updated guidelines cover comprehensively diagnosis and referral, staging, pathology, pre-operative investigations, surgical management (local treatment, groin treatment, sentinel lymph node procedure, reconstructive surgery),(chemo)radiotherapy, systemic treatment, treatment of recurrent disease (vulvar, inguinal, pelvic, and distant recurrences), and follow-up. Management algorithms are also defined. IntrOdUCtIOn Vulvar cancers are relatively uncommon, ranking asthe nineteenth most common cause of cancer incidence in European women with approximatively 16 506 new cases in 2020, and affect predominatly elderly women.1 The vast majority are squamous cell carcinomas. Epidemiologic risk factors associated with vulvar cancer are notably age, human papillomavirus (HPV) infection prevalence, smoking, HIV infection, vulvar intraepithelial neoplasia, and lichensclerosus. As part of its mission to improve the quality of care for women with gynecological cancers across Europe, the European Society of Gynaecological Oncology (ESGO) first published in 2017 evidence-based guidelines in order to improve the management of patients with vulvar cancer within a multidisciplinary setting.2 Given the body of new evidence addressing the management of vulvar cancer, ESGO decided to update these evidence-based guidelines and moreover to cover new topics in order to provide comprehensive guidelines on all relevant issues of diagnosis and treatment in vulvar cancer. These guidelines are intended for use by gynecological oncologists, general gynecologists, gynaecologic surgeons, radiation oncologists, p

FAQs

What is the purpose of the 2023 ESGO vulvar cancer guideline update?

To update evidence-based guidance for managing patients with vulvar cancer using new evidence and to cover additional topics so relevant diagnosis and treatment issues are addressed comprehensively.

How were recommendations developed when scientific evidence was limited?

New data from a systematic search were reviewed and critically appraised; when no clear evidence existed, judgment was based on professional experience and consensus of the international development group.

What areas of care does the updated guideline cover?

It covers diagnosis and referral, staging, pathology, pre-operative investigations, surgical management, (chemo)radiotherapy, systemic treatment, management of recurrent disease, and follow-up, including management algorithms.

Sep 24, 2026

Uploaded by Sophia Brooks