ISSVD NEWSLETTER-NEWS AND UPDATES
From our President
Colleen Stockdale, MD, MS
For the Northern Hemisphere spring is upon us – a time of rebirth and awakening.

And so, we look forward to coming together as a Society for our XXVI World Congress in Dublin July 18 to 20, 2022! There we will gather to renew friendships and make new ones! We will have the opportunity to learn the latest developments from around the world and share ideas to explore and expand our interests with one another.

I encourage you all to seek out opportunities and collaborate to expand and build your ideas… it may lead you to improve your practice, your patient’s quality of life, your career, and most certainly – you may find a new colleague who shares your passion.

This is “our strength” – individually, we each face our patient from a different perspective. We have different backgrounds and approaches – all good. But we need each other to be great. Together we see the whole person (no longer just a patient) as we share our knowledge.

I look forward to learning from you all soon!

Colleen
From our Secretary General
 Pedro Vieira Baptista, MD
Dear colleagues and friends,

Si hortum in bibliotheca habes, nihil deerit.
(“If you have a garden and a library, you have everything you need”)
Marcus Tullius Cicero
 
More than 2 millennia ago, Cicero dixit. If you still are in doubt whether or not to fly (or drive, or sail!) to Dublin next July, here you have your answer. Add to this a great and comprehensive scientific program, the chance to gather with the ISSVD family and networking and, for some, if possible, a few days of vacation!
We live in days of fear and uncertainty, but science cannot stop. We all committed our lives to science and to relieve suffering, specifically those of women. How often to women during appointments, while facing some troublesome vulvovaginal condition do you say: “if it was a man’s problem, certainly there would be more research and better therapeutical options…”. Certainly, I am not sure if that really is the case. But, what if it is? We do not control the pharmaceutical industry and their agenda, but we have our role and responsibilities – if we give up, who will advocate for better care? We are not always dealing with cancer, but very often we have in front of us women in tremendous suffering.

We gather to discuss and foster science, not only because we are passionate, but also because we assumed women’s wellbeing as our life mission!

If you are still in doubt… Don’t be anymore and join us in Dublin! See you soon!

From our Executive Director
Debbie Roepe
Go n-éirí an bóthar leat

You have likely heard the famous Irish blessing: "May the road rise up to meet you/ May the wind be always at your back/ May the sun shine warm upon you face". We are certainly feeling like the luck of the Irish has been with us and are looking forward to seeing each other face to face, whether that be in Dublin or via the virtual platform.

If you plan to join us live, I encourage you to make your bookings now! July and August are busy times in Ireland and with the Covid restrictions lifted it is really booking fast.

Be sure to visit our event website for all of the information you need. If you still have questions, feel free to reach out to us at issvd@issvd.org.
Upcoming Events
See you in 109 Days!

XXVI WORLD CONGRESS and INTERNATIONAL VULVOVAGINAL DISEASE UPDATE (PG COURSE)
EARLY RATES END APRIL 1

Wow, can you believe it? We are actually in the final stages of planning to meet together face to face. You can expect some great scientific exchange at this event and we are thrilled to have had such a great show of support.

Register now with no risk....

  • Decide now and change your mind later if you want to attend virtually or live.
  • No cancellation fee until July 1, 2022

Be sure to visit our EVENT WEBSITE to find out all of the details about both the World Congress and the International Vulvovaginal Disease Update. Be sure to view all of the Blue Tabs:

ACCOMMODATIONS. AIRFARE DISCOUNTS. SCIENTIFIC PROGRAM. CME. REGISTRATION INFO.
Vulvar Clinic Resource
Have you visited our Diagnosis Tools Webpage? We have valuable resources there!

Help us compile an international list of vulvar providers/clinics. Add any vulvar practices, providers, clinics you are aware of to this google sheet which can always be accessed from the ISSVD website under Diagnosis/Tools.
Manuscript Review
Swift BE, Tigert M, Nica A, Covens A, Vicus D, Parra-Herran C, Kupets R, Osborne R, Gien LT. Gynecol Oncol. 2022 Feb;164(2):393-397.
Reviewed By:
Dr. Debra Heller
Department of Pathology, Immunology, & Laboratory Medicine
Rutgers-New Jersey Medical School
Newark, NJ, USA

Background: Groin lymph node status is a significant prognostic feature of vulvar squamous cell carcinoma. Sentinel lymph node sampling has become commonplace in gynecologic oncologic surgery for vulvar squamous cell carcinoma, and may avoid significant morbidity for the patient by preventing unnecessary groin dissections.
 
Paper reviewed-This paper looked at the accuracy of frozen section examination of sentinel nodes in vulvar squamous cell carcinoma
 
Methodology: This was a retrospective review of cases of vulvar SCC from 2008-2020 that were unifocal and less than 4 cm and had clinically negative groin nodes, who underwent frozen section assessment of sentinel nodes. Frozen section and final pathology results were compared. Patient outcomes (recurrence location and groin recurrence free survival) were assessed.
 
Results: Overall there was high accuracy of frozen section/final diagnosis of the 173 patients in this series, however, there were 1 false positive and 4 false negative frozen section results, 2 with individual tumor cells, 1 micrometastasis, and 1 macrometasis. Comparison of frozen and permanent sections showed a sensitivity of 89.7%, specificity of 99.5%, PPV of 97.2% and NPV of 98.2%. Frozen results were used to determine need for immediate inguinofemoral lymphadenectomy. The authors reported no compromise in patient outcomes in their series.
 
Weaknesses of paper-Retrospective reviews may have missing data. The authors noted the lack of a control group who had complete inguinofemoral dissection to compare groin recurrence rates. In addition, pathology results were retrieved from reports, most likely containing diagnoses from multiple pathologists, rather than having a single pathologist slide re-review.
 
Where does this leave us?- In this study frozen section was marginally less accurate in detecting low volume metastatic disease compared to macrometastasis, but the clinical significance of individual tumor cells and micrometastases is uncertain. The authors felt frozen section performance overall led to sparing some patients the potential morbidity of inguinofemoral lymphadenectomy without compromise in outcomes. None of the false negative cases had reoperation for groin dissection, three undergoing adjuvant radiation, and one had treatment delayed (the macrometastasis patient) by Covid as of the time of this paper. No groin recurrences occurred in the 4 patients at the time of this publication. Comparison of frozen section and permanent section is an ongoing quality assurance indicator in pathology departments. It is well known among pathologists that frozen sections have limitations. The quality of the prepared slide is never as good as a permanent section that has undergone full processing. In addition, positivity of nodes, particularly if low volume, may not show up until deeper sections are cut on permanent sections or immunohistochemistry is performed. Overall, frozen section is being utilized appropriately in this setting, to determine the extent of procedure. Clinicians need to be aware that while a good modality, frozen sections will never be 100% accurate.
 
 
Members Spotlight
Many thanks to Annemarie Dixe, NP
Annemarie Dixe is passionate about the success of ISSVD as an organization. Since attending the ISSVD World Congress in Torino and networking with the 'greats', she has worked tirelessly to help bring ISSVD to the attention of many.

As co-chair of the Development committee she has worked diligently to assist us in finding sponsors for the upcoming event.

She also serves on the membership committee and has been committed to finding ways to increase member engagement.

She took it upon herself to create a collaboration with her local community by bringing the ISSVD Basic Course to the Physician Assistant program at Le Moyne College in Syracuse New York. This has proven to be a successful partnership for ISSVD and has also proven that early education for medical residents and advanced practice providers in Vulvovaginal Diseases is imperative and greatly needed and welcomed by the students. Annemarie is very passionate about increasing the awareness and education of Vulvovaginal Disease.

Perhaps you saw her video on social media? Helping to spread the word about ISSVD. Would you be interested in creating a video about your experience with the ISSVD? If so, email us at issvd@issvd.org.
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