For radiation planning, IFLN assessment with imaging and subsequent IFLN lymphadenectomy or US-guided FNAB is recommended. If lymph node metastases are identified at imaging and confirmed at lymphadenectomy or US-guided FNAB, the radiation field should encompass primary tumor, pelvis, and groin nodal basin. If no lymph node metastases are detected at imaging and subsequent lymphadenectomy, reduced EBRT coverage may be considered. Patients presenting with distant metastases beyond the pelvis (TNM any T or N designation and M1 beyond pelvis or FIGO IVB) are treated primarily with chemotherapy and, when appropriate, EBRT for locoregional disease control and symptom palliation. CT Abdomen and Pelvis Contrast-enhanced CT of abdomen and pelvis may be considered in patients with primary tumors >4 cm; urethral, vaginal, or anal involvement; or clinical suspicion for lymph node metastases. However, CT of chest, abdomen, and pelvis or FDG-PET/CT is preferred in this group. Size enlargement and abnormal pattern of enhancement are the main criteria used to detect lymph node metastases on CT. Complete lymphadenectomy or, alternatively, US-guided FNAB is performed if imaging findings are suspicious for lymph node metastases [6]. CT Chest, Abdomen, and Pelvis Contrast-enhanced CT of chest, abdomen, and pelvis may be considered for patients with primary tumors >4 cm; urethral, vaginal, or anal involvement; or clinical suspicion for lymph node metastases. Size enlargement and abnormal pattern of enhancement are the main criteria used to detect lymph node metastases on CT. Complete lymphadenectomy or, alternatively, US-guided FNAB is performed if imaging findings are suspicious for lymph node metastases [6]. Staging and Follow-up of Vulvar Cancer and/or abnormal pattern of contrast enhancement were observed. CT had sensitivity of 60%, specificity of 90%, PPV of 37.5%, and NPV of 95.7% for detection of IFLN metastases.
Staging and Follow up of Vulvar Cancer. For radiation planning, IFLN assessment with imaging and subsequent IFLN lymphadenectomy or US-guided FNAB is recommended. If lymph node metastases are identified at imaging and confirmed at lymphadenectomy or US-guided FNAB, the radiation field should encompass primary tumor, pelvis, and groin nodal basin. If no lymph node metastases are detected at imaging and subsequent lymphadenectomy, reduced EBRT coverage may be considered. Patients presenting with distant metastases beyond the pelvis (TNM any T or N designation and M1 beyond pelvis or FIGO IVB) are treated primarily with chemotherapy and, when appropriate, EBRT for locoregional disease control and symptom palliation. CT Abdomen and Pelvis Contrast-enhanced CT of abdomen and pelvis may be considered in patients with primary tumors >4 cm; urethral, vaginal, or anal involvement; or clinical suspicion for lymph node metastases. However, CT of chest, abdomen, and pelvis or FDG-PET/CT is preferred in this group. Size enlargement and abnormal pattern of enhancement are the main criteria used to detect lymph node metastases on CT. Complete lymphadenectomy or, alternatively, US-guided FNAB is performed if imaging findings are suspicious for lymph node metastases [6]. CT Chest, Abdomen, and Pelvis Contrast-enhanced CT of chest, abdomen, and pelvis may be considered for patients with primary tumors >4 cm; urethral, vaginal, or anal involvement; or clinical suspicion for lymph node metastases. Size enlargement and abnormal pattern of enhancement are the main criteria used to detect lymph node metastases on CT. Complete lymphadenectomy or, alternatively, US-guided FNAB is performed if imaging findings are suspicious for lymph node metastases [6]. Staging and Follow-up of Vulvar Cancer and/or abnormal pattern of contrast enhancement were observed. CT had sensitivity of 60%, specificity of 90%, PPV of 37.5%, and NPV of 95.7% for detection of IFLN metastases.