Contributions of the newly revised 2018 international federation of gynecology and obstetrics staging of cervical cancer

Introduction. According to the latest data from International Agency for Research on Cancer from 2018, global burden of cancer cervical cancer is the fourth most common cancer in women worldwide. The aim of this article was to present the contributions of the new, revised 2018 International Federation of Gynecology and Obstetrics staging of carcinoma of the cervix uteri, allowing much more precise staging with the use of any imaging modalities and/or pathological findings to allocate the stage and provide more effective treatment. International Federation of Gynecology and Obstetrics staging system. The main changes in the new staging system were made in IB stage of the disease, which now includes 3 subgroups i.e. substages for every 2 cm increments in tumor size: stage IB1 (< 2 cm), stage IB2 disease (2 to < 4 cm), and stage IB3 (? 4 cm). This system also incorporates the lymph node status into stage III cervical cancer, allowing imaging and/or pathological findings of lymph nodes to the pelvic and/or para-aortic nodes to assign stage IIIC disease. Conclusion. The main goal of the new staging system revision was to improve the accuracy of staging in order to provide more refined understanding of prognostic groups and facilitate better treatment for women with invasive cervical cancer.

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Comparing survival outcomes for cervical cancer based on the 2014 and 2018 International Federation of Gynecology and Obstetrics staging systems

Scientific Reports ◽

10.1038/s41598-021-86283-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Wonkyo Shin ◽

Tae Young Ham ◽

Young Ran Park ◽

Myong Cheol Lim ◽

Young-Joo Won

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Staging System ◽

International Federation ◽

Lymph Node Status ◽

Survival Outcomes ◽

Stage Iiic ◽

Figo Staging ◽

Gynecology And Obstetrics ◽

Staging Systems

AbstractThe International Federation of Gynecology and Obstetrics (FIGO) cervical cancer staging system was modified in 2018, introducing new stage IB subdivisions and new lymph node status considerations in stage IIIC. We compared cervical cancer survival outcomes according to the 2014 and 2018 FIGO staging systems. We selected 10% of cervical cancer cases (2010–2015) from the Korean national cancer registry (2010–2015) through a systematic sampling method. We collected information using a collaborative stage data collection system and evaluated the results according to both staging systems. The log-rank test was used to analyze overall survival differences. No significant difference in survival was observed between 2018 subdivisions IB1/IB2/IB3 (P = 0.069), whereas a considerable difference was observed between these subdivisions according to histological subtypes. In the 2018 FIGO staging system, stage IIIC had better survival than stage IIIA/IIIB (P < 0.001). We observed considerable heterogeneity in 2018 stage IIIC related to the corresponding stages of the 2014 staging system (stages IA1–IIIB). The size of the primary cervical mass was related to survival (P < 0.001). In conclusion, using lymph node status to define stage IIIC captured a broad range of prognoses. The inclusion of primary tumor size considerations may improve the staging accuracy of advanced cervical cancer.

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Treatment of cervical cancer in the Republic of Srpska

Medicinski pregled ◽

10.2298/mpns1112588l ◽

2011 ◽

Vol 64 (11-12) ◽

pp. 588-591 ◽

Cited By ~ 1

Author(s):

Nenad Lucic ◽

Zora Antonic ◽

Vesna Ecim ◽

Dragica Draganovic ◽

Ljiljana Latinovic

Keyword(s):

Cervical Cancer ◽

Postoperative Complications ◽

Radical Hysterectomy ◽

Invasive Cervical Cancer ◽

Figo Stage ◽

International Federation ◽

Gynecology And Obstetrics ◽

The Republic ◽

Banja Luka ◽

Cervical Tumors

Introduction. Since 1897, when the first radical hysterectomy with lymphadenectomy was done by Wertheim in Vienna, this operation has had the central role in the surgical treatment of invasive cervical tumors. Material and methods. In the period from 1997 to 2010, 177 patients diagnosed with invasive cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 - II were operated at the Department of Obstetrics and Gynecology in Banja Luka. All patients underwent radical hysterectomy by Wertheim - Meigs. The aim of this study is to present the technique of this operation, as well as its effectiveness in the treatment of cervical cancer. Results. The distribution of the patients having invasive cervical cancer according to the International Federation of Gynecology and Obstetrics classification was as follows: I B1 - 35.67%, I B2 - 23.17%, II A - 15.48%, II B - 25.68% on average is 21.3 removed lymph glands. The rate of intraoperative and postoperative complications was 8 (4.51%) and 17 (9.60%), respectively. Of the 26 patients who were operated in the period from 2005 - 2010, 13 had stage II B according to the International Federation of Gynecology and Obstetrics; there were 6 lethal outcomes (23.08) and the five-year survival rate was 76.92%. Discussion and conclusion. By applying the proper surgical technique and early prevention of immediate complications, we achieved satisfactory results in operative morbity and mortality, intraoperative and postoperative complications of the lesion for radical surgery by the Wertheim- Meigs-in the treatment of cancer of the uterus in the I B - II B stage according to the International Federation of Gynecology and Obstetrics classification.

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

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001257 ◽

2020 ◽

Vol 30 (6) ◽

pp. 873-878 ◽

Cited By ~ 4

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.

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A reappraisal of the international federation of gynecology and obstetrics staging system for cervical cancer. A study of patterns of care

Cancer ◽

10.1002/1097-0142(19920115)69:2<482::aid-cncr2820690235>3.0.co;2-8 ◽

1992 ◽

Vol 69 (2) ◽

pp. 482-487 ◽

Cited By ~ 34

Author(s):

Rachelle M. Lanciano ◽

Minhee Won ◽

Gerald E. Hanks

Keyword(s):

Cervical Cancer ◽

Staging System ◽

International Federation ◽

Patterns Of Care ◽

Gynecology And Obstetrics

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Robotic Versus Laparoscopic Radical Hysterectomy in Cervical Cancer Patients: A Matched-Case Comparative Study

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000232 ◽

2014 ◽

Vol 24 (8) ◽

pp. 1466-1473 ◽

Cited By ~ 25

Author(s):

Tae-Hyun Kim ◽

Chel Hun Choi ◽

June-Kuk Choi ◽

Aera Yoon ◽

Yoo-Young Lee ◽

...

Keyword(s):

Cervical Cancer ◽

Radical Hysterectomy ◽

Surgical Outcomes ◽

Invasive Cervical Cancer ◽

Operating Time ◽

International Federation ◽

Complication Rates ◽

Laparoscopic Radical Hysterectomy ◽

Gynecology And Obstetrics ◽

Estimated Blood Loss

ObjectiveThis study aimed to compare initial surgical outcomes and complication rates of patients with early-stage cervical cancer who underwent robotic radical hysterectomy (RRH) and conventional laparoscopic radical hysterectomy (LRH).MethodsPatients diagnosed with invasive cervical cancer (International Federation of Gynecology and Obstetrics stage I-IIA) who underwent RRH (n = 23) at Samsung Medical Center from January 2008 to May 2013 were compared with matched patients who underwent LRH (n = 69) during the same period. The 2 surgical groups were matched 3:1 for variables of age, body mass index, International Federation of Gynecology and Obstetrics stage, histological subtype, tumor size, and node positivity. All patient information and surgical and postoperative follow-up data were retrospectively collected.ResultsOperating time was significantly longer (317 vs 236 minutes; P < 0.001) in the RRH group compared with the LRH group but mean estimated blood loss was significantly reduced in the RRH group (200 vs 350 mL; P = 0.036). Intraoperative and postoperative complications were not significantly different between the 2 groups (4.3% for RRH vs 1.45% for LRH; P = 0.439). Recurrences were 2 (8.7%) in the RRH and 7 (10.1%) in the LRH group. The overall 3-year recurrence-free survival was 91.3% in RRH group and 89.9% in the LRH group (P = 0.778).ConclusionsAlthough operating time was longer in the RRH cases because of lesser experience on robotic platform, we showed that surgical outcomes and complication rate of RRH were comparable to those of LRH. In addition, surgical skills for LRH easily and safely translated to RRH in case of experienced laparoscopic surgeon.

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Clinicopathological risk factors in the light of the revised 2018 International Federation of Gynecology and Obstetrics staging system for early cervical cancer with staging IB

Medicine ◽

10.1097/md.0000000000019714 ◽

2020 ◽

Vol 99 (16) ◽

pp. e19714

Author(s):

Jing Zeng ◽

Pengpeng Qu ◽

Yuanjing Hu ◽

Peisong Sun ◽

Ji Qi ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Staging System ◽

International Federation ◽

Gynecology And Obstetrics ◽

Early Cervical Cancer

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Radical hysterectomy in surgical treatment of invasive cervical cancer at the Department of gynecology and obstetrics in Novi Sad in the period 1993-2013.

Medicinski pregled ◽

10.2298/mpns1508227d ◽

2015 ◽

Vol 68 (7-8) ◽

pp. 227-233

Author(s):

Srdjan Djurdjevic ◽

Sanja Stojanovic ◽

Milos Pantelic ◽

Dragan Nikolic ◽

Marijana Basta-Nikolic ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Nodes ◽

Radical Hysterectomy ◽

Invasive Cervical Cancer ◽

International Federation ◽

Stage I ◽

Stage Ii ◽

Gynecology And Obstetrics ◽

Paraaortic Lymph Nodes ◽

Novi Sad

Introduction. During the period from 1993 - 2013, 175 women with invasive cervical cancer underwent radical hysterectomy sec. Wertheim-Meigs at the Department of Gynecology and Obstetrics, Clinical Center of Vojvodina in Novi Sad. Indications for radical hysterectomy comprise histopathologically confirmed invasive cervical cancer in stages I B 1 - II B according to the International Federation of Gynecology and Obstetrics. Material and Methods. Stage of the disease or extent of the disease spread to the adjacent structures was assessed in accordance with the International Federation of Gynecology and Obstetrics staging system from 2009. Exclusion criteria were all other stages of this disease: I A and stages higher than II B, as well as the absence of definite histological confirmation of the cervical cancer (primary endometrial or vaginal cancer which infiltrates the uterine cervix). Prior the operation, the following had to be done: the imaging of pelvis and abdomen, chest X-ray in two directions, electrocardiography, internist and anesthesiological examination. Results. The patients? age ranged from 24-79 years (x : 46 years), and the operation duration was 120-300 minutes (x : 210 min.). Stage I B 1 was found in 64.6% of operated patients, 14.8% of the patients were in stage I B 2, 9.1% were in stage II A and 11.4 % were in stage II B. Blood loss during the operation ranged from 50-800 ml (on average 300 ml), and the number of removed lymph nodes per operation was 14-75 (x : 32). Intraoperative and postoperative complications developed in 6.8% of and 17.7% of patients, respectively. Recurrence was reported in 22 (12.5%) patients, most often in paraaortic lymph nodes (3.4%) and parametria (2.8%), while the overall 5-year survival rate was 87% until 2008. Concluision. Wertheim-Meigs radical hysterectomy is a basic surgical technique for the treatment of initial stages of invasive cervical cancer.

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