From FIGO-2009 to FIGO-2018 in women with early-stage cervical cancer; Does the revised staging reflect risk groups?

Sponholtz, S; Mogensen, Ole; Schledermann, Doris; Parner, Erik Thorlund; Markauskas, Algirdas; Frøding, Ligita Paskeviciute; Fuglsang, Katrine; Holm, Jorun; Bjørnholt, Sarah Marie; Jensen, Pernille Tine

doi:10.1016/j.ygyno.2021.08.026

Cited by 9 publications

(11 citation statements)

References 27 publications

(41 reference statements)

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“…The revised staging was proposed to allow better differentiation of prognostic outcomes and facilitate better clinical management [2]. However, this revision caused a stage migration for a large proportion of women with early stage cervical cancer [3]. Women previously staged as IB1 stage disease based on lateral extent more than 7 mm with depth of invasion < 5 mm, are now considered FIGO stage 2018 IA disease and are possibly eligible for less radical surgery.…”

Section: Introductionmentioning

confidence: 99%

“…However, clinical trials, such as the SHAPE trial (NCT01658930), are still awaited to further guide the paradigm of treatment in patients with tumors < 2 cm horizontal width [4]. Matsuo et al validated the revised staging FIGO 2018 for stage IB and IIIC disease specifically, but further large cohort studies assessing the prognostic significance of the revised FIGO are lacking [3,5]. In addition, the new FIGO staging system, in contrast to FIGO treatment guidelines, does not incorporate other known prognostic factors, such as histopathological factors and lymph-vascular space invasion (LVSI), and therefore may not fully reflect risk groups [2,6,7].…”

Section: Introductionmentioning

confidence: 99%

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Does the New FIGO 2018 Staging System Allow Better Prognostic Differentiation in Early Stage Cervical Cancer? A Dutch Nationwide Cohort Study

Eikelder

Hinten

Smits

et al. 2022

Cancers

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The FIGO 2018 staging system was introduced to allow better prognostic differentiation in cervical cancer, causing considerable stage migration and affecting treatment options. We evaluated the accuracy of the FIGO 2018 staging in predicting recurrence free (RFS) and overall survival (OS) compared to FIGO 2009 staging in clinically early stage cervical cancer. We conducted a nationwide retrospective cohort study, including 2264 patients with preoperative FIGO (2009) IA1, IA2 and IB1 cervical cancer between 2007–2017. Kaplan–Meier analyses were used to assess survival outcomes. Logistic regression was used to assess risk factors for lymph node metastasis and parametrial invasion. Stage migration occurred in 48% (22% down-staged, 26% up-staged). Survival data of patients down-staged from IB to IA1/2 disease were comparable with FIGO 2009 IA1/2 and better than patients remaining stage IB1. LVSI, invasion depth and parametrial invasion were risk factors for lymph node metastases. LVSI, grade and age were associated with parametrial invasion. In conclusion, the FIGO 2018 staging system accurately reflects prognosis in early stage cervical cancer and is therefore more suitable than the FIGO 2009 staging. However subdivision in IA1 or IA2 based on presence or absence of LVSI instead of depth of invasion would have improved accuracy. For patients down-staged to IA1/2, less radical surgery seems appropriate, although LVSI and histology should be considered when determining the treatment plan.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does the New FIGO 2018 Staging System Allow Better Prognostic Differentiation in Early Stage Cervical Cancer? A Dutch Nationwide Cohort Study

Eikelder

Hinten

Smits

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…(2.8%) in a prospective study [20]. Likewise, in the prospective SENTICOL study, the authors found a low risk of metastases in tumours with < 10 mm depth of invasion and no LVSI (3% isolated tumour cells and 1% micrometastases) [21].…”

Section: Discussionmentioning

confidence: 81%

A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases

Wenzel

Hardie

Moncada‐Torres

et al. 2023

European Journal of Cancer

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“…The staging criteria for the current study were adopted from the 2009 version, and clinical examination was considered as the main basis for staging. Sponholtz et al 9 reported an increase in LNM with increasing FIGO Stage, with no lymph node metastasis in Stages IA1 and IA2, but 89.47% in Stage IB1. In our study, the LNM rates were 20.1% and 27.6% for Stages I and II, respectively, similar to previous studies.…”

Section: Discussionmentioning

confidence: 98%

Development of a nomogram for predicting pelvic lymph node metastasis in cervical squamous cell carcinoma

Yang

Zhao

et al. 2022

Intl J Gynecology & Obste

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Objective To develop and validate a nomogram for predicting pelvic lymph node metastasis (LNM) in cervical squamous cell carcinoma (SCC). Methods This was a retrospective study that included 715 patients with cervical SCC who underwent radical hysterectomy and bilateral pelvic lymphadenectomy between 2009 and 2018. Logistic regression analysis was used to identify independent risk factors for pelvic LNM. Based on these risk factors, a nomogram predicting LNM risk was constructed and internally validated using the bootstrapping resampling method. Results The rate of LNM in FIGO (the International Federation of Gynecology & Obstetrics) Stage IA2–IIA2 cervical SCC was 24.2%. In multivariate analysis, FIGO Stage II, moderately differentiated or poorly differentiated histology, abnormally elevated serum SCC‐antigen, and triglyceride were identified as independent risk factors for LNM. Tumor size greater than 2 cm and parametrial involvement had borderline significance. Ultimately, the nomogram contained the six variables mentioned above, showing positive calibration and positive discrimination. The area under the receiver operating characteristic curvewas 0.827 and the bootstrap‐validated C‐index was 0.827. The Youden index of this paper was 0.540. Conclusions We developed and validated a nomogram to predict pelvic LNM in SCC based on clinical data, which can help physicians develop an optimal treatment strategy.

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From FIGO-2009 to FIGO-2018 in women with early-stage cervical cancer; Does the revised staging reflect risk groups?

Cited by 9 publications

References 27 publications

Does the New FIGO 2018 Staging System Allow Better Prognostic Differentiation in Early Stage Cervical Cancer? A Dutch Nationwide Cohort Study

Does the New FIGO 2018 Staging System Allow Better Prognostic Differentiation in Early Stage Cervical Cancer? A Dutch Nationwide Cohort Study

A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases

Development of a nomogram for predicting pelvic lymph node metastasis in cervical squamous cell carcinoma

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