International Federation of Gynecology and Obstetrics Staging Classification for Cancer of the Ovary, Fallopian Tube, and Peritoneum: Estimation of Survival in Patients With Node-Positive Epithelial Ovarian Cancer

2015 ◽  
Vol 25 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Augusto Pereira ◽  
Tirso Pérez-Medina ◽  
Javier F. Magrina ◽  
Paul M. Magtibay ◽  
Ana Rodríguez-Tapia ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Staging System ◽  
Peritoneal Metastases ◽  
International Federation ◽  
Anatomical Location ◽  
Abdominal Lymph Node ◽  
Node Positive ◽  
Figo Staging ◽  
Gynecology And Obstetrics

ObjectiveThe objective of this study was to determine the survival of patients with node-positive epithelial ovarian cancer according to the 2014 International Federation of Gynecology and Obstetrics (FIGO) staging system.Materials and MethodsWe performed a retrospective chart review. Data from all consecutive patients with node-positive epithelial ovarian cancer (stages IIIC and IV) who underwent cytoreductive surgery at the Mayo Clinic from 1996 to 2000 were reassessed to evaluate the prognostic significance of the new FIGO stages. Multivariate Cox regression was performed, and Kaplan-Meier survival curves constructed.ResultsThe distribution of the restaged patients was as follows: IIIA1, 23 patients (IIIA1i, 9 patients; and IIIA1ii, 14 patients); IIIA2, 3 patients; IIIB, 4; IIIC, 67 patients; IVA, 4 patients; and IVB, 15 patients. In the univariate analysis, the relative risk for positive nodes greater than 10 mm on the longer axis was 2.57 and 3.00 for patients with microscopic peritoneal disease, compared with patients with microscopic positive nodes. However, the difference was not statistically significant. Moreover, the univariate analyses revealed statistically significant differences for 2014 FIGO stages (IIIA, IIIB, IIIC, and IVA-B), anatomical sites of peritoneal metastases, and disease staged at IIIC because of the presence of omental metastases. Multivariate analysis showed that survival was higher in patients restaged to IIIA-B than in those restaged to IIIC and IV (hazard ratios, 2.75 and 3.16, respectively; P = 0.002). The hazard ratio for patients with abdominal peritoneal metastases was 2.76 compared with patients with pelvic peritoneal metastases (P = 0.001).ConclusionsThe current 2014 FIGO staging system for ovarian cancer successfully correlates survival, anatomical location of peritoneal metastases, and extra-abdominal lymph node metastases.

scholarly journals Development and Validation of a Nomogram Based on CA125 Levels for Predicting Progression-Free Survival in Patients with Ovarian Cancer

2020 ◽  
Author(s):  
Minjun He ◽  
Chuanbo Xie ◽  
Jun Huang ◽  
Wei Wei ◽  
Yin Wang ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
External Validation ◽  
Progression Free Survival ◽  
Staging System ◽  
Curve Analysis ◽  
Discriminative Ability ◽  
Decision Curve Analysis ◽  
Free Survival ◽  
Figo Staging ◽  
Gynecology And Obstetrics

Abstract Background We aimed to develop and validate a nomogram incorporating CA125 levels after three cycles of chemotherapy for predicting progression-free survival (PFS) in patients with ovarian cancer.Methods The nomogram was developed in a primary cohort of 491 patients with stage II-IV ovarian cancer. Performance was assessed by concordance index (C-index), calibration curve, and decision curve analysis, and compared with the International Federation of Gynecology and Obstetrics (FIGO) staging system. The predictive value of CA125 levels after three cycles of chemotherapy was evaluated. The model was subjected to bootstrap internal validation. An independent cohort of 81 patients was used for external validation.Results CA125 levels after three cycles of chemotherapy were significantly associated with PFS. Five variables, including CA125 levels were selected to develop the nomogram. The nomogram demonstrated adequate discrimination, with a bootstrap-corrected C-index of 0.708, and good calibration. External validation of the nomogram achieved excellent discrimination (C-index, 0.724) and calibration. CA125 levels after three adjuvant chemotherapy cycles showed a marginally significant increment of discrimination to the nomogram in the primary cohort (C-index, 0.708 vs 0.668; P = 0.097). Superior discriminative ability was observed in the nomogram when compared with the FIGO staging system only in the primary cohort (C-index, 0.708 vs 0.578; P < 0.001). Decision curve analysis demonstrated that our nomogram was clinically useful.Conclusion We developed and validated a nomogram incorporating CA125 levels after three chemotherapy cycles for PFS prediction in ovarian cancer. This nomogram showed well-predictive performance and easy clinical application.

Revised 2018 International Federation of Gynecology and Obstetrics (FIGO) cervical cancer staging: A review of gaps and questions that remain

2020 ◽  
Vol 30 (6) ◽  
pp. 873-878 ◽  
Author(s):  
Gloria Salvo ◽  
Diego Odetto ◽  
Rene Pareja ◽  
Michael Frumovitz ◽  
Pedro T Ramirez
Keyword(s):  
Cervical Cancer ◽  
Early Stage ◽  
Staging System ◽  
Cancer Staging ◽  
International Federation ◽  
Imaging Modalities ◽  
Early Stage Disease ◽  
Figo Staging ◽  
Gynecology And Obstetrics ◽  
Parametrial Involvement

Recently the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer was published. In this most recent classification, imaging modalities and pathologic information have been added as tools to determine the final stage of the disease. Although there are many merits to this new staging for cervical cancer, including more detailed categorization of early-stage disease as well as information on nodal distribution, the classification falls short in clarifying areas of controversy in the staging system. Many unanswered questions remain and, as such, a number of gaps lead to further debate in the interpretation of relevant clinical data. Factors such as measurement of tumor size, definition of parametrial involvement, ovarian metastases, lower uterine segment extension, lymph node metastasis, and imaging modalities are explored in this review. The goal is to focus on items that deserve further discussion and clarification in the most recent FIGO staging for cervical cancer.

scholarly journals Stage-Specific Outcomes of Patients With Uterine Leiomyosarcoma: A Comparison of the International Federation of Gynecology and Obstetrics and American Joint Committee on Cancer Staging Systems

2009 ◽  
Vol 27 (12) ◽  
pp. 2066-2072 ◽  
Author(s):  
Oliver Zivanovic ◽  
Mario M. Leitao ◽  
Alexia Iasonos ◽  
Lindsay M. Jacks ◽  
Qin Zhou ◽  
...  
Keyword(s):  
Uterine Cancer ◽  
Staging System ◽  
International Federation ◽  
Uterine Leiomyosarcoma ◽  
Figo Staging ◽  
American Joint Committee ◽  
Gynecology And Obstetrics ◽  
Staging Systems ◽  
Ajcc Staging System ◽  
Ajcc Staging

Purpose Uterine leiomyosarcoma (LMS) is staged by the modified International Federation of Gynecology and Obstetrics (FIGO) staging system for uterine cancer. We aimed to determine whether the American Joint Committee on Cancer (AJCC) soft tissue sarcoma (STS) staging system is more accurate in predicting progression-free survival (PFS) and overall survival (OS). Patients and Methods Patients with uterine LMS who presented at our institution from 1982 to 2005 were staged retrospectively according to a modified FIGO staging system and the AJCC STS staging system. The predictive accuracy of the two staging systems was compared using concordance estimation. Results Two hundred nineteen patients had sufficient clinical and pathologic information to be staged under both systems; 132 patients were upstaged using the AJCC staging system, whereas only four were downstaged. Stage-specific PFS and OS rates for stages I, II, and III differed substantially between the two staging systems. In both systems, there was prognostic overlap between stages II and III. Thus, despite the marked stage-specific differences in 5-year PFS and OS rates for stages I, II, and III, both systems had similar concordance indices. Conclusion Estimates of stage-specific PFS and OS for uterine LMS were altered substantially when using the AJCC versus FIGO staging system. Adjuvant treatment strategies should be tested in patients at substantial risk for disease progression and death. Neither the FIGO nor AJCC staging system is ideal for identifying such patients, suggesting a need for a uterine LMS-specific staging system to better target patients for trials of adjuvant therapies.

scholarly journals New Hypothesis on Pathogenesis of Ovarian Cancer Lead to Future Tailored Approaches

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
P. Rescigno ◽  
I. Cerillo ◽  
R. Ruocco ◽  
C. Condello ◽  
S. De Placido ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Standard Treatment ◽  
Staging System ◽  
International Federation ◽  
Precursor Lesions ◽  
Histological Subtype ◽  
Tailored Therapy ◽  
Gynecology And Obstetrics ◽  
Response To Chemotherapy ◽  
New Hypothesis

In the last decades, management of epithelial ovarian cancer (EOC) has been based on the staging system of the International Federation of Gynecology and Obstetrics (FIGO), and different classifications have been proposed for EOC that take account of grade of differentiation, histological subtype, and clinical features. However, despite taxonomic efforts, EOC appears to be not a unique disease; its subtypes differ for epidemiological and genetic risk factors, precursor lesions, patterns of spread, response to chemotherapy, and prognosis. Nevertheless, carboplatin plus paclitaxel combination represents the only standard treatment in adjuvant and advanced settings. This paper summarizes theories about the classification and origin of EOC and classical and new prognostic factors. It presents data about standard treatment and novel agents. We speculate about the possibility to create tailored therapy based on specific mutations in ovarian cancer and to personalize prevention.

2743 The revised 2014 FIGO staging system for epithelial ovarian cancer: Is a subclassification of stage IV justified?

2015 ◽  
Vol 51 ◽  
pp. S544
Author(s):  
B. Ataseven ◽  
P. Harter ◽  
F. Heitz ◽  
A. Traut ◽  
S. Prader ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Stage Iv ◽  
Staging System ◽  
Figo Staging

scholarly journals Development and validation of a nomogram to predict survival outcome among epithelial ovarian cancer patients with site-distant metastases: a population-based study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Wang ◽  
Shixuan Wang ◽  
Wu Ren
Keyword(s):  
Ovarian Cancer ◽  
Prognostic Factors ◽  
Bone Metastasis ◽  
Epithelial Ovarian Cancer ◽  
Lung Metastasis ◽  
Lymphatic Metastasis ◽  
Staging System ◽  
Distant Metastases ◽  
Figo Staging ◽  
Staging Surgery

Abstract Background Increasing evidence indicates that site-distant metastases are associated with survival outcomes in patients with epithelial ovarian cancer. This study aimed to investigate the prognostic values of site-distant metastases and clinical factors and develop a prognostic nomogram score individually predicting overall survival (OS, equivalent to all-cause mortality) and cancer specific survival (CSS, equivalent to cancer-specific mortality) in patients with epithelial ovarian cancer. Methods We retrospectively collected data on patients with epithelial ovarian cancer from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2016. Multivariate Cox regression was performed to identify survival trajectories. A nomogram score was used to predict long-term survival probability. A comparison between the nomogram and the International Federation of Gynecology and Obstetrics (FIGO 2018) staging system was conducted using time-dependent receiver operating characteristic (tROC) curve. Results A total of 131,050 patients were included, 18.2, 7.8 and 66.1% had localized, regional and distant metastases, respectively. Multivariate analysis identified several prognostic factors for OS including race, grade, histology, FIGO staging, surgery, bone metastasis, liver metastasis, lung metastasis, and lymphatic metastasis. Prognostic factors for CSS included grade, site, FIGO staging, surgery, bone metastasis, brain metastasis, lung metastasis, lymphatic metastasis, and insurance. Following bootstrap correction, the C-index of OS and CSS was 0.791 and 0.752, respectively. These nomograms showed superior performance compared with the FIGO 2018 staging criteria (P < 0.05). Conclusions A novel prognostic nomogram score provides better prognostic performance than the FIGO 2018 staging system. These nomograms contribute to directing clinical treatment and prognosis assessment in patients harboring site-distant metastases.

When and Who Should Perform Epithelial Ovarian Cancer Surgery?

2018 ◽  
Vol 28 (3) ◽  
pp. 594-599 ◽  
Author(s):  
Cecilia Escayola ◽  
Juan Jose Torrent ◽  
Gwenaël Ferron ◽  
François Quenet ◽  
Denis Querleu
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Postgraduate Training ◽  
Training Programs ◽  
Residual Tumor ◽  
International Federation ◽  
Gynecologic Malignancies ◽  
Debulking Surgery ◽  
Current Review ◽  
Gynecology And Obstetrics

AbstractEpithelial ovarian cancer is the most common cause of death due to gynecologic malignancies. Most patients will be diagnosed at an advanced stage, and despite progress in both surgical procedures and novel targeted therapies, the overall survival of these patients remains very low. Among prognostic factors, the International Federation of Gynecology and Obstetrics stage and residual tumor after debulking surgery are the most widely reported. The current review aims to highlight the disparities in the treatment of patients with ovarian cancer and the need for postgraduate training programs in order to accredit gynecologic oncologists. Despite an increase over the centralization of these patients, many are still not receiving specialized surgery.

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