Squamous cell carcinoma of the vulva: a review of present management and future considerations.

INTRODUCTION: Although a relatively uncommon disease, the treatment of vulvar cancer has changed considerably over the years and has been under considerable focus due to its past overtreatment and apparent increase in incidence. The purpose of this review is to describe the recommended management of the most commonly encountered vulvar carcinomas based on the most recent available literature. Areas covered: The clinical environment of squamous cell vulvar cancers are illustrated in order to describe the potential pitfalls and limitations of treatment. Then, by examining published data on the treatment efficacy, find those that are best at limiting morbidity and maximizing patient outcomes. In addition, effective prevention of HPV-related disease will be included as its limitation of disease can be considered an aspect of treatment. The benefits and limitations of medical and surgical modalities as well as the evolving discussion surrounding lymph node sampling and the novel role of genomics will also be considered. Expert commentary: Great care should be taken by the gynecologic oncology community regarding prevention and continuing efforts of limiting surgical morbidity while providing quality care. Although sentinel lymph node dissection is a controversial topic, greater attention should be paid to clinical trials to delineate the data, but also to limit our own biases in counseling patients.