Vulvar Cancer: 2021 Revised FIGO Staging System and the Role of Imaging

Abstract

Vulvar cancer is a rare gynecological malignancy. It constitutes 5–8% of all gynecologic neoplasms, and squamous cell carcinoma is the most common variant. This article aims to review the etiopathogenesis revised 2021 International Federation of Gynecology and Obstetrics (FIGO) classification and emphasize imaging in the staging of vulvar cancer. The staging has been regulated by FIGO since 1969 and is subjected to multiple revisions. Previous 2009 FIGO classification is limited by the prognostic capability, which prompted the 2021 revisions and issue of a new FIGO classification. Although vulvar cancer can be visualized clinically, imaging plays a crucial role in the staging of the tumor, assessing the tumor extent, and planning the management. In addition, sentinel lymph node biopsy facilitates the histopathological staging of the draining lymph node, thus enabling early detection of tumor metastases and better survival rates.

The Utility of Pre-Treatment Inflammation Markers as Associative Factors to the Adverse Outcomes of Vulvar Cancer: A Study on Staging, Nodal Involvement, and Metastasis Models

“…Patient data points were extracted from medical records, including age, BMI, LNM, DM, staging, and pre-operative laboratory results. Patients were categorised according to whether they had LNM status or not based on the outcomes of lymphadenopathy imaging (ultrasonography, computed tomography/CT, and/or magnetic resonance imaging/MRI) [2,25], which were then verified by pathology testing (cytology and/or histology) [26]. Imaging techniques were used to identify DM as distant cancer spread to other body parts (such as the lungs, liver, bones, and skin) and, if possible, pathology testing [27].…”

“…Imaging techniques were used to identify DM as distant cancer spread to other body parts (such as the lungs, liver, bones, and skin) and, if possible, pathology testing [27]. However, most of this investigation's findings depended on imaging studies, such as CT, MRI, positron emission tomography and CT (PET-CT), PET-MRI, and chest X-ray, because not all instances could be validated by pathology [25,28]. Cancer staging was determined based on the International Federation of Gynaecology and Obstetrics (FIGO) 2021 revised classification system [29], except for vulvar melanoma, which were classified using the tumour, node, and metastasis (TNM) system [30].…”

Establishment and validation of a nomogram for estimating the overall survival of vulvar squamous cell carcinoma patients aged 50 years or older

“…As the fourth most common gynecologic tumor [1], the primary malignant tumor of the vulva accounts for 4% of all cancers of the female genital tract [2]. It is more prevalent in elderly women and has a median age at diagnosis of about 68 years [3,4].…”

The Role of Ultrasound in the Evaluation of Inguinal Lymph Nodes in Patients with Vulvar Cancer: A Systematic Review and Meta-Analysis

“…Moreover, a mass in the groin can be reported in the case of inguinal lymph node involvement. Vulvar cancer is confined to the primary site in 59% of cases, regional lymph nodes are involved in 30% and distant metastasis can be found in 6% of cases [5]. Thus, vulvar cancer frequently spreads to the groin, and inguinofemoral lymph node (LN) involvement is the most significant prognostic factor for survival [6,7].…”