IGCS 2024 Vulvar/Vaginal Master Sessions: State of Art-Recording

Video Transcription

Video Summary

The Völver Vaginal Cancer Master Session featured expert discussions on the state-of-the-art management of vulvar and vaginal cancers, emphasizing multidisciplinary approaches. Patient advocate Aisling Wright shared her personal journey with vulvar cancer, highlighting the physical and psychological challenges post-treatment, including compromised sexual well-being and chronic pain.<br /><br />Clinicians detailed case studies of locally advanced vulvar cancer, illustrating treatment strategies such as chemoradiation, surgical resection, and reconstructive techniques to restore form and function. Dr. Luigi Davides presented a case treated with chemoradiation followed by pelvic exenteration due to residual tumor. Surgical reconstruction was emphasized by Dr. Thais Barth, who highlighted flap techniques improving both aesthetics and mobility, vital for patient quality of life.<br /><br />Advances in systemic therapy, as discussed by Dr. Neil Horowitz, included the NRG GOG279 trial demonstrating improved pathologic complete response rates with combined chemotherapy and IMRT radiation. Immunotherapy shows promise but with modest response rates, and ongoing studies aim to improve outcomes.<br /><br />Radiation oncologist Dr. Junzo Chino reviewed advanced radiation techniques, underscoring the role of HPV status in radiosensitivity and postoperative management of lymph nodes and margins.<br /><br />Survivorship concerns, particularly psychosexual dysfunction affecting up to 90% of patients within the first year, were addressed by Dr. Yvonne Amara. Emphasis was placed on overcoming barriers to initiating conversations about sexual health and creating multidisciplinary support teams.<br /><br />Dr. Carlos Andrada discussed challenges in low- and middle-income countries, including delayed diagnosis, limited resources, and treatment accessibility, advocating for vaccination, training, and global collaborations.<br /><br />Innovations in pathology were presented, focusing on distinguishing HPV-associated and independent vulvar neoplasias with prognostic implications. The session concluded with new insights into rare lower genital tract soft tissue tumors, like NTRK-rearranged sarcomas and aggressive angiomyxomas, underscoring the need for accurate diagnosis and tailored treatment.<br /><br />Overall, the session highlighted evolving diagnostic, therapeutic, and supportive care aspects aimed at improving outcomes and quality of life for women with vulvar and vaginal cancers.

Keywords

Vulvar cancer

Vaginal cancer

Multidisciplinary management

Chemoradiation

Surgical reconstruction

NRG GOG279 trial

Immunotherapy

HPV status

Psychosexual dysfunction

Low- and middle-income countries

Pathology innovations

Soft tissue tumors