Molecular classification of vulval cancer: Comparing pre-surgical biopsy and surgical specimen of radical vulvectomy from the same patients

Background Classification of vulvar carcinoma (VCX) into one of the three molecular subtypes has significant prognostic and therapeutic impact. An HPV-associated lesion that is p16 positive and p53 wild type represents improved prognosis compared to other subtypes. HPV-independent VCX, mostly associated with lichen sclerosus is characterized by TP53-alteration (i.e. aberrant p53-expression) and p16 non-aberrant staining. A third (minor) subtype is characterized by normal staining for both markers. It has been shown that patients with p53-aberrant tumors may benefit from more radical surgical approach. Contrary, HPV-high risk associated VCA (with p16-block positivity) represent better response to chemoradiation.