Datasets

Carcinomas of the Vulva

Scope

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.

Publication History

These datasets were developed with the kind support of the International Society of Gynecological Pathologists (ISGyP).

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 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 Tumour 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.
  • Other minor updates were also included.
    • To reference this dataset please use the following citation: McCluggage WG, Bosse T, Focchi G, Gilks CB, Hoang L, Howitt BE, McAlpine JN, Ordi J, Singh N, Wong RW, Lax SF (2023). Carcinoma of the Vulva Histopathology Reporting Guide. 2nd edition. International Collaboration on Cancer Reporting; Sydney, Australia. ISBN: 978-1-922324-37-5.

    1st edition – August 2021

    • To reference this dataset please use the following citation: McCluggage WG, Bosse T, Focchi G, Gilks CB, Hoang L, Howitt BE, McAlpine JN, Ordi J, Singh N, Wong RW, Lax SF (2021). Carcinoma of the Vulva Histopathology Reporting Guide. 1st edition. International Collaboration on Cancer Reporting; Sydney, Australia. ISBN: 978-1-922324-22-1.
    • Read more on the Carcinoma of the vulva dataset (1st edition) from the journal article written by the dataset authors: Data Set for the Reporting of Carcinomas of the Vulva: Recommendations From the International Collaboration on Cancer Reporting (ICCR). Hoang L, Webster F, Bosse T, Focchi G, Gilks CB, Howitt BE, McAlpine JN, Ordi J, Singh N, Wong RW, Lax SF, McCluggage WG. Int J Gynecol Pathol. 2022 Nov 1;41(Suppl 1):S8-S22. doi: 10.1097/PGP.0000000000000900. Epub 2022 Oct 10.

    Expert Committee

    All editions of the dataset for Carcinoma of the vulva was developed by the following international team:

    • Chair and Series Champion – W Glenn McCluggage, UK
    • ICCR representative – Sigurd Lax, Austria

    Domain experts:

    • Tjalling Bosse, The Netherlands
    • Gustavo Focchi, Brazil
    • Blake Gilks, Canada
    • Lien Hoang, Canada
    • Brooke Howitt, USA
    • Jessica McAlpine, Canada
    • Jaume Ordi, Spain
    • Naveena Singh, UK
    • Richard Wong, Hong Kong SAR China
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