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Radical surgery approach, such as en bloc resection, was the first therapeutic option and the standard care for many years, even if burdened with a high complication rate and frequently disfiguring. Taussing and Way introduced radical vulvectomy approach with en bloc bilateral inguinal\u2010femoral lymphadenectomy; modified radical vulvectomy was developed, with a wide radical excision of the primary tumor. The role of inguinofemoral lymphadenectomy (mono or bilateral) changed in the years too, particularly with the advent of SLN biopsy as minimally invasive surgical approach for lymph node staging, in patients with unifocal cancer &lt;4\u00a0cm, without suspicious groin nodes. More personalized and conservative surgical approach, consisting of wide local or wide radical excisions, is necessary to reduce complications as lymphedema or sexual disfunction. The optimal surgical management of vulvar cancer needs to consider dimensions, staging, depth of invasion, presence of carcinoma at the surgical margins of resection and grading, with the goal of making the treatment as individualized as possible.<\/jats:p>","DOI":"10.1111\/jog.15103","type":"journal-article","created":{"date-parts":[[2021,12,28]],"date-time":"2021-12-28T10:42:42Z","timestamp":1640688162000},"page":"533-540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["The giant steps in surgical downsizing toward a personalized treatment of vulvar cancer"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4388-0082","authenticated-orcid":false,"given":"Andrea","family":"Giannini","sequence":"first","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Experimental Clinical Oncology IRCSS\u2010Regina Elena National Cancer Unit Institute  Rome Italy"},{"name":"Department of Medical and Surgical Sciences and Translational Medicine, PhD Course in \u201cTranslational Medicine and Oncology\u201d Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ottavia","family":"D'Oria","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Translational Medicine, PhD Course in \u201cTranslational Medicine and Oncology\u201d Sapienza University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benito","family":"Chiofalo","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Experimental Clinical Oncology IRCSS\u2010Regina Elena National Cancer Unit Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Bruno","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Experimental Clinical Oncology IRCSS\u2010Regina Elena National Cancer Unit Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermelinda","family":"Baiocco","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Experimental Clinical Oncology IRCSS\u2010Regina Elena National Cancer Unit Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Mancini","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Experimental Clinical Oncology IRCSS\u2010Regina Elena National Cancer Unit Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"Mancari","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Experimental Clinical Oncology IRCSS\u2010Regina Elena National Cancer Unit Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Vincenzoni","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Experimental Clinical Oncology IRCSS\u2010Regina Elena National Cancer Unit Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Cutillo","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Experimental Clinical Oncology IRCSS\u2010Regina Elena National Cancer Unit Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Vizza","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Department of Experimental Clinical Oncology IRCSS\u2010Regina Elena National Cancer Unit Institute  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,28]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Vulvar cancer \u2013 cancer stat facts.2018[cited Aug 29]. 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