Methods: A systematic literature search of English and German articles was conducted (PubMed, Embase, Scopus, Web of Science) from 1980 to December 2023, including the search terms “vulvar Neoplasms”, “vulvar cancer”, “vulvar carcinoma”, “vulvar tumor”, ”vulvar tumour”, “vulvar malignancy”, “vulvar malignant”, “ki-67”, “MIB-1”, “MIB1”, “proliferative index”, “proliferative activity”, “mitotic index”, and “mitotic count”. Here, MKI67 is linked to vulvar neoplasm.