Objective: The aim of the present review is to provide an up-to-date overview for the conservative treatment of vulvar cancer. Sentinel lymph-node (SLN) biopsy is a promising new method for reducing the morbidity of traditional surgical therapy. Method: A bibliographic search was conducted through PubMed. The keywords used in the search were: vulvar cancer, sentinel lymph node, diagnostic methods in vulvar cancer, and reviews in vulvar cancer. Results: This review presents the most recent data on presurgical diagnostic methods, the pathohistologic criteria to perform surgery, SLN accuracy, and its clinical importance. Conclusions: The surgical treatment of vulvar cancer has changed dramatically in more than 100 years. However, in the last 30 years, new promising techniques have emerged to reduce morbidity. The new more-conservative techniques have to be performed by well-trained surgeons who pay attention to the preoperative evaluation of the patient as well. SLN and fusion imaging computed tomography (FICT)/positron emission tomography–CT are, and will be, even more helpful tools for minimally invasive surgery for vulvar cancer. (J GYNECOL SURG 27:245)
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