New Therapies in Vulvar Cancer

Major advances have been made in vulvar cancer treatment during the last decades, exploring less morbid treatment options without compromising survival. The introduction of the sentinel lymph node procedure is one of the most important advances in surgical management of early-stage vulvar cancer patients, resulting in a significant decrease in treatment-related morbidity. Groningen International Study on Sentinel nodes in Vulvar cancer (GROINSS-V) II is currently investigating the safety of replacing inguinofemoral lymphadenectomy by radiotherapy in patients with a metastatic sentinel lymph node. Targeted therapy in vulvar cancer is still in its infancy; preliminary results from pilot studies are promising, however large studies are lacking. Since vulvar cancer originates by two different pathways, an human papillomavirus (HPV)-dependent and HPV-independent type, studies on targeted therapy should take this into account.