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.

Autor:	Preti M; Department of Surgical Sciences, University of Torino, Torino, Italy., Joura E; Department of Gynecology and Gynecologic Oncology, Comprehensive Cancer; Center, Medical University of Vienna, Vienna, Austria., Vieira-Baptista P; Hospital Lusiadas Porto, Porto, Portugal; Lower Genital Tract Unit, Centro Hospitalar de São João, Porto, Portugal., Van Beurden M; Centre for Gynecological Oncology Amsterdam, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands., Bevilacqua F; Department of Surgical Sciences, University of Torino, Torino, Italy., Bleeker MCG; Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands., Bornstein J; Galilee Medical Center and Azrieli Faculty of Medicine, Bar-Ilan, Israel., Carcopino X; Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE UMR 7263, 13397, Marseille, France., Chargari C; Radiation Therapy, Gustave Roussy Cancer Campus, Paris, France., Cruickshank ME; Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom., Erzeneoglu BE; Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey., Gallio N; Department of Surgical Sciences, University of Torino, Torino, Italy., Heller D; Rutgers New Jersey Medical School, Newark, NJ., Kesic V; Department of Obstetrics and Gynecology, University of Belgrade, Belgrade, Serbia., Reich O; Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria., Stockdale CK; Department of Obstetrics & Gynecology, University of Iowa, Iowa City, IA., Temiz BE; Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey., Woelber L; Department of Gynecology, Hamburg-Eppendorf University Medical Center, Dysplasia Center Hamburg, Jerusalem Hospital, Hamburg, Germany., Planchamp F; Clinical Research Unit, Institut Bergonie, Bordeaux, France., Zodzika J; Department of Obstetrics and Gynaecology Rīga Stradiņš university, Riga, Latvia., Querleu D; Department of Obstetrics and Gynecologic Oncology, University Hospital, Strasbourg, France; Division of Gynecologic Oncology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy., Gultekin M; Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Jazyk:	angličtina
Zdroj:	Journal of lower genital tract disease [J Low Genit Tract Dis] 2022 Jul 01; Vol. 26 (3), pp. 229-244. Date of Electronic Publication: 2022 Jun 21.
DOI:	10.1097/LGT.0000000000000683
Abstrakt:	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). Competing Interests: C.C. served on advisory boards for GSK and MSD and reports support for clinical research from Roche and TherAguiX. D.Q. served on advisory boards for Mimark. E.J. served on advisory boards for MSD and Roche Diagnostics and reports grants for traveling from MSD. J.B. reports support for clinical research from Merck (Galilee Medical Center Research Fund) and was a member of speakers’ bureau for MSD Israel. The other authors declared they have no conflicts of interest. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP.)
Databáze:	MEDLINE
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