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September 2026

This Month in Vaginal & Vulvar Cancer Research

This Month in Vaginal Cancer Research

Vaginal cancer is one of the rarest gynecologic cancers, so new research arrives in small steps, and every study carries extra weight for the community that has waited for answers. September's work stretched from prevention to survivorship. A nationwide Swedish study showed that most people with vaginal cancer receive guideline-based care, but women aged 80 and older are often treated less intensively and have much poorer survival. For vaginal precancer, modern image-guided internal radiation controlled disease well with manageable side effects, and an early immunotherapy trial produced a few long-lasting responses across different vaginal cancer types. On the prevention side, an international HPV expert group cautioned that no product yet clears HPV infection itself, which keeps vaccination and screening at the center, and a new FIGO position paper offers clearer guidance on menopause care after treatment.

The papers highlighted here represent a selection of those published during the month. The papers were selected and summarized by AI. Accuracy of the summaries was confirmed by a scientist. This digest incorporates only open-access research articles that are free to be read by the entire community and that are explicitly licensed to be shared and reused.

Age still shapes how vaginal cancer is treated and how people fare

Most of what we know about vaginal cancer comes from small series, so population-wide data showing how care is delivered in everyday practice are especially valuable.

  • If you or a loved one is older and facing vaginal cancer, it is worth asking whether full staging and standard treatment are possible, because this study found large age-related gaps. Using Sweden's national gynecologic cancer register, researchers followed 252 women diagnosed from 2011 to 2020. Most received definitive radiation therapy, with or without chemotherapy, and care generally followed international guidelines. Among women aged 80 and older, however, staging was skipped in 18%, a quarter of those with stage I disease received only palliative (comfort-focused) treatment, and none who had radiation also received chemotherapy. Five-year relative survival for stage I–II disease was 28% in women aged 80 and older compared with 84% in those under 60, which the authors say points to both diagnostic and treatment compromises. This is population-level evidence. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

Modern brachytherapy is an effective option for vaginal precancer

VaIN, or vaginal intraepithelial neoplasia, refers to abnormal cell changes in the vaginal lining that can progress to cancer if untreated. It can be hard to treat when it appears in several spots or comes back after earlier treatment.

  • If you have high-grade VaIN, image-guided brachytherapy (a form of internal radiation where a radioactive source is placed inside the vagina, guided by imaging) may be a strong option, especially when surgery is difficult or other treatments have not worked. In an Italian center, all 10 patients with VaIN3 treated this way had their disease controlled at one year, with no short-term side effects. Four patients had moderate long-term effects, mainly vaginal atrophy (thinning and dryness of the vaginal lining) and, in one case, vaginal narrowing. The team's review of earlier published studies found similar results. This is early clinical evidence from a small group, but it supports brachytherapy as an effective definitive treatment in selected patients. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

Immunotherapy shows early promise in vaginal cancer

People with advanced vaginal cancer have few proven treatment options, so even small trials of new approaches matter.

  • If your vaginal cancer is advanced, immunotherapy trials may be worth exploring with your care team. The DART trial, which studies rare tumors, tested two immunotherapy drugs together: ipilimumab, which blocks a checkpoint called CTLA-4, and nivolumab, which blocks one called PD-1. In 7 people with vaginal cancers of several types, 2 had their tumors shrink: one complete response that lasted nearly 15 months and one partial response that lasted about 45 months. About 4 in 10 had their disease controlled for at least six months. Serious side effects occurred in 4 of the 7 patients, with no new safety concerns. This is early clinical evidence from a very small group. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

Rare vaginal cancer subtypes need their own playbook

Clear cell carcinoma, melanoma, and sarcoma of the vagina are uncommon even within this rare cancer, and each behaves differently.

  • This case report is a reminder that heavy or unusual bleeding and discharge that does not respond to treatment deserves a careful look, even in a teenager. A 17-year-old developed weakness and seizures from cancer that had spread to the brain. For three months before, she had heavy menstrual bleeding with foul-smelling discharge that did not improve with treatment. Doctors then found a vaginal mass, which proved to be clear cell adenocarcinoma, a rare type of vaginal cancer. Unusually, it was not linked to diethylstilbestrol (DES), the best-known risk factor for this subtype. Brain spread from this cancer is extremely rare, and the authors call for standard management guidelines. This is a single case and should be read as illustrative. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

HPV vaccination remains the best prevention, and unproven HPV treatments fall short

HPV, the human papillomavirus, causes most vaginal cancers as well as other anogenital cancers, so preventing HPV infection is one of the most powerful tools this community has.

  • If you have been offered a gel, supplement, or other product promising to "clear" HPV, this expert statement is worth knowing about. The International Papillomavirus Society reviewed the evidence and found that no treatment has yet been proven to durably eliminate HPV infection itself. Some treatments can help specific HPV-related lesions; for example, topical 5-fluorouracil has helped cervical precancers regress in some trials. Other options, including probiotics, nutritional supplements, and vaginal gels, lack strong evidence. For now, the best approach remains vaccination, screening, monitoring, and evidence-based treatment of precancer. This statement is practice-guiding. (Read the full paper)
  • A study of 187 adolescent girls and young women in rural South Africa found high rates of HPV infection, especially among those living with HIV (85% compared with 65%). Encouragingly, no HPV types 16 or 18 were found in participants of the age eligible for the national vaccination program, although their vaccination status was not confirmed. Other high-risk types that are covered by the broader nine-type (nonavalent) vaccine were common, which suggests broader vaccines could add protection in this setting. This is a preprint, which means it has not yet been peer reviewed. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

Menopause care after gynecologic cancer can be personalized

Treatment can bring on early menopause, with hot flashes, vaginal dryness, sexual changes, and sleep problems that affect quality of life for years.

  • If you are a survivor of vaginal cancer and struggling with menopause symptoms, hormone therapy may be an option. A FIGO position paper concludes that systemic menopausal hormone therapy may suit carefully chosen survivors of gynecologic cancers that are not hormone-dependent, including most vulvar, vaginal, cervical, and epithelial ovarian cancers. People with hormone-sensitive tumors should generally avoid systemic hormones, but local vaginal hormones and non-hormonal options remain available. This is practice-guiding expert guidance. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

What Does This Mean for Me?

Age alone should not decide your treatment. The Swedish study suggests that older women are sometimes staged and treated less fully, with much poorer survival. If you are older, or caring for someone who is, you might ask: "Is full staging possible for me, and would standard treatment such as chemoradiation be safe given my overall health?"

If your cancer is advanced, ask about clinical trials. Early results from the DART trial show that combination immunotherapy can produce lasting responses for some people with vaginal cancer, though not most. Because vaginal cancer is rare, trials that group several rare tumors together are often the main way to access new treatments. A good question is: "Are there immunotherapy or rare-tumor trials I could join?"

Menopause symptoms after treatment are worth raising. For many vaginal cancer survivors, hormone therapy may be a safe option, and local or non-hormonal treatments can help when it is not. You might ask: "Is my cancer hormone-sensitive, and which menopause treatments are safe for me?"

This digest is prepared by OCRA (Ovarian Cancer Research Alliance) for patients, caregivers, and advocates. It is intended to inform, not to guide individual treatment decisions. Please speak with your care team about what research findings may mean for your specific situation.

Sources

The citations below are grouped to match the sections above. "Directly referenced" papers are the ones summarized in that section; the remaining entries are on-topic papers that were either not discussed above or are behind access restrictions.

Age still shapes how vaginal cancer is treated and how people fare

Directly referenced:

1. Hellman K, et al. "Primary treatment and relative survival by stage and age in vaginal carcinoma: a population-based SweGCG study." Acta Oncol. September 30, 2026. PMID 42813614. https://doi.org/10.2340/1651-226X.2026.45598

Related citations, access restricted:

2. Carvajal LJ, et al. "Trends in Incidence Rates of Anogenital Cancers in Costa Rica, 1996-2022." Int J Cancer. September 15, 2026. PMID 42740696. https://doi.org/10.1002/ijc.70664 (subscription access)

Modern brachytherapy is an effective option for vaginal precancer

Directly referenced:

3. Lancellotta V, et al. "Image-guided interventional radiotherapy (modern brachytherapy) for treatment of vaginal intraepithelial neoplasia: single-institution experience and systematic literature review and meta-analysis." Strahlenther Onkol. September 2026. PMID 42189190. https://doi.org/10.1007/s00066-026-02549-6

Related citations, access restricted:

4. Durán Méndez CF, et al. "Clinical and pathological outcomes of brachytherapy application for the treatment of high-grade vaginal squamous intraepithelial lesions: a systematic review." Int J Gynecol Cancer. September 2026. PMID 42580935. https://doi.org/10.1016/j.ijgc.2026.104876 (license unconfirmed)

Immunotherapy shows early promise in vaginal cancer

Directly referenced:

5. Chae YK, et al. "A phase II basket trial of Dual Anti-CTLA-4 and Anti-PD-1 Blockade in Rare Tumors (DART) SWOG S1609: vaginal cancer sub cohort results." J Gynecol Oncol. September 2026. PMID 41995270. https://doi.org/10.3802/jgo.2026.37.e92

Additional open-access citations:

6. Wang H, et al. "Divergent immune ecosystems in HPV-associated and HPV-independent lower anogenital tract malignancies." Front Immunol. September 22, 2026. PMID 42840571. https://doi.org/10.3389/fimmu.2026.1937031 (open access, review of immune differences between HPV-associated and HPV-independent anogenital cancers, including vaginal cancer)

Rare vaginal cancer subtypes need their own playbook

Directly referenced:

7. Buckson EA, et al. "Brain metastasis secondary to primary vaginal clear cell adenocarcinoma not associated with diethylstilbestrol: a case report and a review of the literature." Front Oncol. September 3, 2026. PMID 42755711. https://doi.org/10.3389/fonc.2026.1853333

Related citations, access restricted:

8. Simões Costa N, Santos E Pereira H. "Vaginal melanoma: a rare and challenging diagnosis." BMJ Case Rep. September 28, 2026. PMID 42805624. https://doi.org/10.1136/bcr-2024-260002 (license unconfirmed)

9. Parmar P, Couts KL. "Mucosal Melanoma: Clinical and Biological Implications of Anatomic Site." Pigment Cell Melanoma Res. September 2026. PMID 42760760. https://doi.org/10.1111/pcmr.70120 (subscription access)

10. Yeung MCF, et al. "Integrated Clinicopathologic and Multiomic Profiling Reveals MEIS1-Rearranged Sarcoma as a Distinct Entity With 2 Prognostic Subgroups." Mod Pathol. September 2026. PMID 42471200. https://doi.org/10.1016/j.modpat.2026.101041 (restricted license, CC BY-NC-ND 4.0)

HPV vaccination remains the best prevention, and unproven HPV treatments fall short

Directly referenced:

11. Arroyo Mühr LS, et al. "International Papillomavirus Society statement on reputed treatments for human papillomavirus infection and human papillomavirus-related diseases: evidence, risks, and standards for clinical evaluation." Int J Gynecol Cancer. September 1, 2026. PMID 42680631. https://doi.org/10.1016/j.ijgc.2026.104950

12. Mthembu M, et al. "Prevalence and genotype distribution of human papillomavirus (HPV) among adolescent girls and young women in a high HIV burden rural area of South Africa: a cross-sectional survey." medRxiv. September 11, 2026. PMID 42818429. https://doi.org/10.64898/2026.09.09.26362609

Additional open-access citations:

13. Carvalho TS, et al. "Primary and secondary prevention of cervical cancer during the COVID-19 pandemic in Sao Paulo State, Brazil." Rev Inst Med Trop Sao Paulo. September 18, 2026. PMID 42788601. https://doi.org/10.1590/S1678-9946202668064 (open access, HPV vaccination and screening trends during the COVID-19 pandemic in Brazil)

Related citations, access restricted:

14. Wieland U, Kreuter A. "[Vaccine prevention of HPV-associated diseases]." Dermatologie (Heidelb). September 11, 2026. PMID 42726205. https://doi.org/10.1007/s00105-026-05786-z (license unconfirmed)

15. Karlsen E, et al. "Rationale and design of a clinical trial of a reduced dosing schedule for the nonavalent human papillomavirus vaccine in women living with HIV: The NOVA-HIV study." Contemp Clin Trials. September 15, 2026. PMID 42744154. https://doi.org/10.1016/j.cct.2026.108475 (license unconfirmed)

16. Pingarrón Santofimia C, et al. "Local carboxymethyl β-glucan and polycarbophil in women positive for human papillomavirus: a prospective observational study." Drugs Context. September 14, 2026. PMID 42757327. https://doi.org/10.7573/dic.2026-5-1 (restricted license, CC BY-NC-ND 4.0)

17. Pareja R, et al. "FIGO/IGCS statement on the efficacy of topical treatments for high-risk human papillomavirus in preventing CIN 3+ lesions." Int J Gynaecol Obstet. September 1, 2026. PMID 42677467. https://doi.org/10.1002/ijgo.71285 (subscription access)

18. Pareja R, et al. "FIGO/IGCS Statement on the efficacy of topical treatments for high-risk human papillomavirus in preventing CIN 3+ lesions." Int J Gynecol Cancer. September 1, 2026. PMID 42680632. https://doi.org/10.1016/j.ijgc.2026.104946 (subscription access)

Menopause care after gynecologic cancer can be personalized

Directly referenced:

19. da Silva-Filho AL, et al. "Menopausal hormone therapy and comprehensive postmenopausal care in gynecologic cancer survivors: A position paper from the FIGO Committee on Women at Menopausal Age." Int J Gynaecol Obstet. September 2026. PMID 42483786. https://doi.org/10.1002/ijgo.71188

Related citations, access restricted:

20. Tóth I, et al. "From vaginal morbidity to sexual health: rethinking sexual rehabilitation after gynecological cancer through a survivor-informed patient expert perspective." Int J Gynecol Cancer. September 2026. PMID 42520499. https://doi.org/10.1016/j.ijgc.2026.104833 (subscription access)

This Month in Vulvar Cancer Research

Vulvar cancer is rare, which means each study carries real weight and research often moves through careful case series, national registries, and international collaborations rather than large trials. This month's research focused on what happens before and after treatment as much as on treatment itself: why some people wait months for a diagnosis, what questions they search for online, and how surgeons can protect sexual function and appearance. A Finnish nationwide study found that today's more personalized approach to surgery is linked to better survival, and a new European quality-of-life questionnaire designed specifically for vulvar cancer moved closer to routine use. In rare subtypes, case reports described striking responses to targeted treatment and chemoradiation in advanced vulvar Paget's disease. Running through the month was a growing appreciation that vulvar cancers arise through two different biological pathways, one driven by HPV and one linked to lichen sclerosus, and that this distinction matters for care.

Getting to a diagnosis sooner, and staging it accurately

Vulvar cancer is often diagnosed late, in part because early symptoms such as itching or soreness are easy to mistake for common skin conditions, and because stigma can make them hard to talk about.

  • If you have a vulvar sore, lump, or itch that does not go away with treatment, asking for a biopsy and a gynecologist's opinion early may save months. In 157 people with vulvar squamous cell carcinoma treated at The Ohio State University, Sakach and colleagues found that one in four waited six months or more from first symptoms to biopsy. Delays were not explained by age, race, insurance, or tumor size; instead, people first seen by non-gynecologic providers were about twice as likely to be delayed and had more visits and trial treatments before anyone took a biopsy. The authors call for earlier biopsy, faster referral, and better education for both patients and clinicians. (Read the full paper)
  • If you have struggled to know whether a vulvar change is normal, a sign of cancer, or a sign of recurrence, you are far from alone. Wouters and colleagues at Amsterdam UMC, working with a Dutch patient organization, analyzed 619 questions posted in online forums in the Netherlands, the United Kingdom, and the United States by people with vulvar cancer or VIN (precancerous cell changes in the surface layer of the vulva). The most common unmet need was uncertainty about how to interpret bodily changes, at every stage from before diagnosis through survivorship, and many questions after treatment concerned wound healing and recovery. The authors recommend starting symptom conversations earlier, preparing people for recovery before surgery, and creating visual educational materials. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

Sentinel lymph node mapping continues to be refined

Sentinel lymph node biopsy, a procedure that tests the first one or two lymph nodes most likely to receive cancer cells, lets many people with early vulvar cancer avoid more extensive groin surgery and its risk of lymphedema (long-term swelling of the leg or groin). This month's studies on new tracer techniques are listed in the Sources.

Check the citations section for a comprehensive list of publications associated with this topic.

Surgery is becoming more personalized, with growing attention to function and appearance

Surgery remains the main treatment for vulvar cancer. Research is now asking not only how to remove the cancer safely, but how to preserve sensation, function, and a sense of wholeness.

  • Today's more tailored approach to vulvar cancer surgery is linked to better survival, though it comes with more complications to manage. Using Finland's national health registry, Mörsky and colleagues at Tampere University compared people treated in 2000 to 2005, when radical surgery was standard, with those treated in 2014 to 2019, after sentinel node biopsy, more limited local excision, and reconstruction became common. Two-year survival rose from 67% to 77%, and the risk of death was lower even after accounting for other health conditions and additional treatment. Complications (8% versus 20%) and repeat operations (6% versus 10%) were more frequent in the later period, which the authors suggest may partly reflect more complex surgery and better record-keeping. (Read the full paper)
  • When vulvar cancer involves the clitoris, reconstruction may help preserve sexual function. Ten Eikelder and colleagues at Radboud University Medical Center described a step-by-step technique adapted from a method first developed for women who have experienced genital cutting. In 18 people who had clitoral reconstruction after cancer surgery, 16 (89%) reported being able to reach clitoral orgasm afterward, the procedure added about 15 minutes, and 2 had complications related to the reconstruction. This is an early case series, and the authors call for prospective studies. (Read the full paper)
  • For medium-sized wounds left after removing a vulvar tumor, a staged repair may offer a practical middle path between simple closure and larger flap surgery. Kagoyama and colleagues at the University of Toyama in Japan described three women, one with squamous cell carcinoma and two with Paget's disease, whose wounds were temporarily covered and then repaired with a meshed advancement flap once margins were confirmed clear. Healing was complete within two weeks of reconstruction, with no major complications or recurrence over five years. With only three patients, this is an illustration of a technique rather than proof that it suits everyone. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

Two biological pathways, HPV-related and lichen sclerosus-related, shape risk, prognosis, and treatment

Vulvar cancers develop along two main paths: one caused by HPV, and one not caused by HPV that often arises in skin affected by lichen sclerosus, a chronic condition that thins and scars vulvar tissue and, in some cases, raises long-term cancer risk. The two behave differently, and research increasingly treats them as distinct diseases.

  • Whether a vulvar cancer is HPV-related may shape how it interacts with the immune system and, in the future, which immunotherapies might work. In a review spanning cancers of the cervix, vulva, vagina, anus, and penis, Wang and colleagues describe how HPV-related tumors carry viral proteins the immune system could recognize, while HPV-independent tumors rely on other signals. They emphasize that evidence for vulvar cancer specifically is limited to small studies and propose a framework for testing biomarkers in future research. This is a conceptual review, not a treatment guide. (Read the full paper)
  • New immune-based treatments being developed for HPV-related cancers may eventually reach people with HPV-related vulvar cancer. A review by Alsalloum and colleagues summarizes therapeutic vaccines that train the immune system to attack HPV-infected cells, engineered T-cell therapies, and combinations with checkpoint inhibitors (drugs that release a brake on the immune system). Most of these approaches remain in early clinical testing. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

Rare subtypes: new treatment responses in Paget's disease and a closer look at melanoma

Rare subtypes such as vulvar Paget's disease (a rare cancer of glandular cells in the skin that usually stays in the surface layer but can become invasive) and vulvar melanoma are uncommon even within vulvar cancer, so individual case reports can offer valuable clues.

  • For people with advanced vulvar Paget's disease whose tumors carry high levels of the HER2 protein, a targeted drug used in breast cancer may be worth considering when other options are exhausted. Thomas and colleagues at Hospices Civils de Lyon in France described a patient whose metastatic HER2-positive vulvar Paget's disease had progressed after surgery, radiation, and trastuzumab with or without paclitaxel. Off-label trastuzumab deruxtecan, an antibody-drug conjugate that carries chemotherapy directly to HER2-positive cells, produced marked responses both inside and outside the brain with acceptable side effects. This is a single case, but it supports testing tumors for HER2 in advanced disease. (Read the full paper)
  • Even widely spread vulvar Paget's disease may respond well to combined chemotherapy and radiation. Park and colleagues at Dong-A University Hospital in Korea described a 70-year-old woman whose invasive vulvar Paget's disease had spread to lymph nodes in the groin, pelvis, abdomen, and above the collarbone. After treatment with radiation and weekly cisplatin chemotherapy, scans six months later showed a complete response. As a single case report, it illustrates a possibility rather than an expected outcome. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

Quality of life and survivorship are getting better tools and practical support

Treatment for vulvar cancer can affect sexual health, body image, comfort, and daily activities. This month brought new tools to measure what matters to patients and practical help for everyday life.

  • A questionnaire built specifically for people with vulvar cancer is close to being ready for routine use, which should make it easier for doctors and researchers to capture what treatment really means for daily life. Led by Froeding and colleagues for the European Organisation for Research and Treatment of Cancer (EORTC), the team gathered input from patients and health professionals across Europe to develop a 36-item module, then pre-tested it with 77 patients at 12 centers in nine countries. Patient feedback led to removing, rewording, and adding items, and final validation is underway. (Read the full paper)
  • If vulvar pain makes cycling uncomfortable, a specially designed saddle may help you get back on your bike. Van de Berg and colleagues at Erasmus MC Cancer Institute in Rotterdam had 50 women with lichen sclerosus, lichen planus, or vulvar cancer try four cutout saddle designs, choose one, and use it at home for one to three months. The share reporting moderate or worse cycling problems fell from 76% to 30%, and 70% reached their personal cycling goal, although overall quality of life and activity levels did not change. (Read the full paper)
  • Many vulvar cancer survivors may be able to use menopausal hormone therapy safely to relieve symptoms such as hot flashes, vaginal dryness, and sleep problems. A position paper from the FIGO Committee on Women at Menopausal Age, led by da Silva-Filho and colleagues, concluded that systemic hormone therapy may suit carefully chosen survivors of gynecologic cancers that are not hormone-dependent, including most vulvar cancers, while vaginal and non-hormonal options remain important for others. (Read the full paper)

Check the citations section for a comprehensive list of publications associated with this topic.

Epidemiology, Access & Health Disparities Research

These studies look at how often vulvar cancer occurs and how outcomes differ between groups of people. They are listed here so researchers and advocates can find them.

Check the citations section for a comprehensive list of publications associated with this topic.

What Does This Mean for Me?

If you have a vulvar symptom that will not go away. Persistent itching, soreness, a lump, or a change in skin color that does not improve with treatment deserves a closer look. It is reasonable to ask for a biopsy or a referral to a gynecologist, especially if you have lichen sclerosus or have already tried several treatments. A helpful question: "Should we biopsy this rather than try another cream?"

If you are preparing for vulvar surgery. Ask your surgeon how the operation will be tailored to you, whether sentinel lymph node biopsy is an option, and what to expect for wound healing and recovery. If the clitoris or a large area of skin may be affected, you can ask whether reconstruction is possible and what it might preserve. Raising sexual health and body image before surgery is entirely appropriate.

If you are living with life after treatment. Your quality of life matters as much as the cancer outcome. Talk with your team about menopause symptoms, sexual health, and comfort in everyday activities; practical solutions, such as hormone therapy where appropriate or even a different bicycle saddle, can make a difference.

Because vulvar cancer is rare, every person who joins a clinical trial, registry, or quality-of-life study helps move the field forward. Ask your care team about trials, or search ClinicalTrials.gov. OCRA's patient support programs and resources at ocrahope.org can help you find information, connect with others, and navigate care.

Sources

The citations below are grouped to match the sections above. "Directly referenced" papers are the ones summarized in that section; the remaining entries are on-topic papers behind access restrictions. This month, every open-access paper is summarized above, so there are no additional open-access citations.

Getting to a diagnosis sooner, and staging it accurately

Directly referenced:

1. Sakach JC, et al. "No time to waste: Evaluation of diagnostic delays in vulvar cancer." Gynecol Oncol. September 2026. PMID 42546435. https://doi.org/10.1016/j.ygyno.2026.07.019

2. Wouters D, et al. "Informational needs in vulvar cancer and precursor conditions: a social listening study." Support Care Cancer. September 22, 2026. PMID 42771088. https://doi.org/10.1007/s00520-026-11240-6

Related citations, access restricted:

3. Olawaiye AB, et al. "The new (version 9) American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging protocol for carcinoma of the vulva." CA Cancer J Clin. September 2026. PMID 42665926. https://doi.org/10.3322/caac.70104 (restricted license, CC BY-NC-ND 4.0)

Sentinel lymph node mapping continues to be refined

Related citations, access restricted:

4. Frøding LP, et al. "Feasibility of real-time near-infrared fluorescence tracer imaging in sentinel lymph node biopsy for vulvar cancer patients." Gynecol Oncol. September 21, 2026. PMID 42767171. https://doi.org/10.1016/j.ygyno.2026.09.010 (license unconfirmed)

5. Kerschbaum A, et al. "Groin Recurrence Rates After Exclusive Indocyanine Green Sentinel Node-Mapping in Early-Stage Vulvar Cancer." Ann Surg Oncol. September 10, 2026. PMID 42722941. https://doi.org/10.1245/s10434-026-20523-5 (license unconfirmed)

6. Bahrehmand K, et al. "[The role of sentinel lymph node biopsy in the management of gynecologic cancers: current evidence and institutional experience]." Magy Onkol. September 2026. PMID 42731005. https://pubmed.ncbi.nlm.nih.gov/42731005/ (free to read, no reuse license)

Surgery is becoming more personalized, with growing attention to function and appearance

Directly referenced:

7. Mörsky MK, et al. "Contemporary surgical management of vulvar cancer is associated with improved survival but increased reoperation rate: A Finnish nationwide study." Gynecol Oncol. September 21, 2026. PMID 42767169. https://doi.org/10.1016/j.ygyno.2026.09.009

8. Ten Eikelder M, et al. "Clitoral reconstructive surgery for patients with vulvar carcinoma." Gynecol Oncol. September 2026. PMID 42480492. https://doi.org/10.1016/j.ygyno.2026.07.013

9. Kagoyama K, et al. "Meshed advancement flap for medium-sized vulvar defects after tumor excision." JPRAS Open. September 2026. PMID 42436662. https://doi.org/10.1016/j.jpra.2026.06.016

Related citations, access restricted:

10. Haidopoulos D, et al. "European Society of Gynecological Oncology Consensus Statement on the prevention of surgical complications in gynecologic oncology." Int J Gynecol Cancer. September 2026. PMID 42520497. https://doi.org/10.1016/j.ijgc.2026.104862 (subscription access)

11. Tran HTT, et al. "Surgical management and outcomes in localized vulvar basal cell carcinoma: a National Cancer Database Study." Int J Gynecol Cancer. September 2026. PMID 42580025. https://doi.org/10.1016/j.ijgc.2026.104849 (subscription access)

12. Agustí N, et al. "The science and conduct of surgical trials in gynecologic oncology: A practical framework." Gynecol Oncol. September 2026. PMID 42664613. https://doi.org/10.1016/j.ygyno.2026.08.013 (subscription access)

Two biological pathways, HPV-related and lichen sclerosus-related, shape risk, prognosis, and treatment

Directly referenced:

13. Wang H, et al. "Divergent immune ecosystems in HPV-associated and HPV-independent lower anogenital tract malignancies." Front Immunol. September 22, 2026. PMID 42840571. https://doi.org/10.3389/fimmu.2026.1937031

14. Alsalloum A, et al. "Advances in immunotherapy for HPV-associated malignancies: emerging strategies and clinical progress." Front Immunol. September 16, 2026. PMID 42819744. https://doi.org/10.3389/fimmu.2026.1897025

Related citations, access restricted:

15. Hampl M, et al. "[Vulvar intraepithelial neoplasia and vulvar cancer]." Dermatologie (Heidelb). September 22, 2026. PMID 42773184. https://doi.org/10.1007/s00105-026-05777-0 (subscription access)

16. Hoang L, et al. "Vulvar Squamous Cell Carcinoma: Scientific Progress and Impacts to Pathology Practice." Int J Gynecol Pathol. September 2026. PMID 42184992. https://doi.org/10.1097/PGP.0000000000001188 (license unconfirmed)

17. Jeffus SK, et al. "Hypertrophic Lichen Sclerosus: A Form of "Atypical" Lichen Sclerosus in the Pathway to HPV-Independent Squamous Cell Carcinoma of the Vulva." Am J Surg Pathol. September 2026. PMID 42219981. https://doi.org/10.1097/PAS.0000000000002574 (subscription access)

18. Shanker EM, et al. "Clinicopathologic and Immunologic Features of Vulvar Lichen Sclerosus and Related Neoplasia: A Comparative Study of Precursor Lesions and VSCC in Premenopausal and Postmenopausal Patients." Int J Gynecol Pathol. September 2026. PMID 42206808. https://doi.org/10.1097/PGP.0000000000001189 (subscription access)

19. Warring SK, et al. "Prognostic implications of HPV and TP53 status in early-stage vulvar squamous cell carcinoma." Gynecol Oncol. September 15, 2026. PMID 42743681. https://doi.org/10.1016/j.ygyno.2026.08.020 (subscription access)

Rare subtypes: new treatment responses in Paget's disease and a closer look at melanoma

Directly referenced:

20. Thomas M, et al. "Dramatic response to trastuzumab-deruxtecan in metastatic HER2-overexpressing vulvar extramammary Paget's disease: A case report." Gynecol Oncol Rep. September 17, 2026. PMID 42824666. https://doi.org/10.1016/j.gore.2026.102213

21. Park S, et al. "Concurrent chemoradiotherapy for metastatic vulvar extramammary Paget's disease involving supraclavicular nodes: a case report." Radiat Oncol J. September 2026. PMID 42634497. https://doi.org/10.3857/roj.2026.00388

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22. Burk JL, et al. "Cervicovaginal cytologic features in patients with Vulvar Paget disease." J Am Soc Cytopathol. September 2026. PMID 42364948. https://doi.org/10.1016/j.jasc.2026.06.001 (license unconfirmed)

23. Fukuda K, et al. "Collision Tumor of Basal Cell Carcinoma and Primary Extramammary Paget Disease: A Case Report and Literature Review." Am J Dermatopathol. September 2026. PMID 42333518. https://doi.org/10.1097/DAD.0000000000003368 (subscription access)

24. Jeffus SK, et al. ""Dark Paget" Cells in Extramammary Paget Disease of the Vulva-Diagnostic Features and Interpretative Pitfalls." Int J Gynecol Pathol. September 2026. PMID 41997580. https://doi.org/10.1097/PGP.0000000000001179 (subscription access)

25. Nakra G, et al. "Adenocarcinoma of Mammary Gland Type of the Vulva." Int J Surg Pathol. September 2026. PMID 41944460. https://doi.org/10.1177/10668969261438130 (subscription access)

26. Matsushima T, et al. "Urethral preservation by direct anastomosis to bilateral gracilis myocutaneous flaps after distal urethrectomy for extramammary Paget disease: A case report." Urol Case Rep. September 23, 2026. PMID 42830838. https://doi.org/10.1016/j.eucr.2026.103623 (restricted license, CC BY-NC-ND 4.0)

27. Recalde Puig P, et al. "Primary vulvar extramammary Paget disease associated with herpes simplex virus infection: A rare case report." Rev Esp Patol. September 1, 2026. PMID 42680132. https://doi.org/10.1016/j.patol.2026.100895 (subscription access)

28. Parmar P, et al. "Mucosal Melanoma: Clinical and Biological Implications of Anatomic Site." Pigment Cell Melanoma Res. September 2026. PMID 42760760. https://doi.org/10.1111/pcmr.70120 (subscription access)

29. Inuzuka M, et al. "Electronegative ERG revealing melanoma-associated retinopathy in a patient with trametinib-associated retinopathy." Doc Ophthalmol. September 2, 2026. PMID 42684571. https://doi.org/10.1007/s10633-026-10146-2 (subscription access)

Quality of life and survivorship are getting better tools and practical support

Directly referenced:

30. Froeding LP, et al. "Phase 1-3 cross-cultural development and pre-testing of the European Organisation of Research and Treatment of Cancer Vulva cancer questionnaire module (EORTC QLQ- VU)." Gynecol Oncol. September 2026. PMID 42492379. https://doi.org/10.1016/j.ygyno.2026.07.014

31. van de Berg NJ, et al. "Personalised cutout saddle selection reduces perineal pain and improves cycling comfort in women with vulvar skin conditions." Appl Ergon. September 2026. PMID 41791297. https://doi.org/10.1016/j.apergo.2026.104759

32. da Silva-Filho AL, et al. "Menopausal hormone therapy and comprehensive postmenopausal care in gynecologic cancer survivors: A position paper from the FIGO Committee on Women at Menopausal Age." Int J Gynaecol Obstet. September 2026. PMID 42483786. https://doi.org/10.1002/ijgo.71188

Epidemiology, Access & Health Disparities Research

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33. Carvajal LJ, et al. "Trends in Incidence Rates of Anogenital Cancers in Costa Rica, 1996-2022." Int J Cancer. September 15, 2026. PMID 42740696. https://doi.org/10.1002/ijc.70664 (subscription access)

34. Setiawati D, et al. "Gynecologic cancers in low- and middle-income countries: Bridging the survival gap." Cancer. September 1, 2026. PMID 42634487. https://doi.org/10.1002/cncr.70518 (free to read, no reuse license)

35. Tran HTT, et al. "Marital status and its association with vulvar melanoma outcomes." Int J Gynecol Cancer. September 2026. PMID 42574967. https://doi.org/10.1016/j.ijgc.2026.104854 (subscription access)

36. Tran HTT, et al. "Racial disparities in survival among patients with vulvar melanoma: A National Cancer Database analysis." J Am Acad Dermatol. September 2026. PMID 42162673. https://doi.org/10.1016/j.jaad.2026.05.039 (subscription access)

A note on how this digest was made: This edition was built by searching PubMed for papers published in September 2026, using targeted searches across the vulvar cancer landscape (sentinel lymph node and groin management, surgery and morbidity, radiation and chemoradiation, lichen sclerosus and VIN/dVIN/HSIL, HPV prevention, rare subtypes, immunotherapy, biomarkers, survivorship, and disparities), plus a dedicated qualitative search. Papers summarized in full are open access under a permitted license (CC0, CC BY, CC BY-SA, CC BY-ND, or CC BY-NC); on-topic papers under other licenses are listed by citation only. A companion methodology report, available separately, documents the full search-and-screening process and every paper reviewed.