Datasets
The dataset has been developed for the pathological reporting of resection specimens of primary carcinomas of the vulva.
In some patients with a prior diagnosis of vulval carcinoma (especially squamous), it is not clear whether a ‘new’ lesion is a recurrence or an independent neoplasm and the dataset can also be used for such tumours, especially when these ‘arise’ from the surface squamous epithelium. Molecular studies have shown that some of these ‘recurrent’ neoplasms exhibit similar mutations and are clonally related to the original tumour and are likely to represent true recurrences while others are clonally unrelated with different mutations and are likely to represent new neoplasms.
In those rare cases where more than one primary tumour is present, separate datasets should be completed for each neoplasm. These should include all the elements in this dataset, except for lymph node status which does not need to be documented separately for each tumour.
Haematopoietic neoplasms, mesenchymal neoplasms, mixed epithelial and mesenchymal neoplasms, malignant melanomas, other non-epithelial malignancies and metastatic tumours are excluded from this dataset.
These datasets were developed with the kind support of the International Society of Gynecological Pathologists (ISGyP).
Minor update to the 2nd edition – Version 2.1 October 2023
2nd edition – October 2023
The 2nd edition of this dataset incorporates the 2021 International Federation of Gynaecology and Obstetrics (FIGO) staging for cancer of the vulva.
SUMMARY OF CHANGES
• Incorporation of the most recent International Federation of Gynaecology and Obstetrics (FIGO) 2021 staging system, which includes modifications to:
o Methodology for measuring depth of invasion (DOI): Now measured from the basement membrane of the deepest, adjacent, dysplastic, tumour-free rete ridge (or nearest dysplastic rete peg) to the deepest point of invasion.
o Tumor involvement of upper 2/3 urethra or vagina, bladder mucosa or rectal mucosa is now considered stage IIIA (formerly stage IVA).
o Removal of number of lymph nodes involved as the divisor for Stage IIIA and IIIB, and replacement with size of lymph node metastasis (≤5 mm is captured under Stage IIIA, >5 mm is captured under Stage IIIB).
o Isolated tumour cells (ITC) within lymph nodes do not now result in tumour upstaging.
• p53 immunohistochemistry is now considered a core item for squamous cell carcinoma (SCC) of the vulva for classification and prognostication purposes.
• Updates to the nomenclature used to describe precursor lesions of vulval SCC.
• Added Neuroendocrine neoplasia and its entities to the WHO Classifications table.
1st edition – August 2021
All editions of the dataset for Carcinoma of the vulva were developed by the following international team:
Domain experts:
