Is the revised 2018 FIGO staging system for cervical cancer more prognostic than the 2009 FIGO staging system for women previously staged as IB disease?

Ayhan, Ali; Aslan, Koray; Bulut, Ayca Nazli; Akıllı, Hüseyin; Öz, Murat; Haberal, Alı; Meydanlı, Mehmet Mutlu

doi:10.1016/j.ejogrb.2019.07.002

Cited by 24 publications

(31 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When a revised staging system is proposed, external validation with population‐based statistics is vital for further application in clinical practice 5,6 . Two retrospective studies demonstrated that the 2018 FIGO staging system was associated with improvement in risk stratification 7,8 . However, the sample sizes (425 and 265) were relatively small, which weakens the plausibility of the results.…”

Section: Introductionmentioning

confidence: 99%

A novel prognostic nomogram utilizing the 2018 FIGO staging system for cervical cancer: A large multicenter study

Tang

Guo

Liu

et al. 2021

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective To evaluate the prognostic performance of the revised 2018 FIGO staging system for cervical cancer. Methods This retrospective multicenter study enrolled cervical cancer patients with 2009 FIGO Stage IA1–IIA2 who underwent surgeries between January 2006 and December 2017 in four tertiary hospitals. Patients were restaged according to the 2018 FIGO staging system by reviewing their medical data. Results Of 3238 cervical cancer patients included, 1841 (56.9%) patients were restaged: 641 (34.9%) due to tumor size, 544 (29.5%) due to lymph node metastasis, 614 (33.4%) due to the inconsistency between pre‐ and postoperative assessments, and 42 due to the cancellation of invasion width in Stage IA. After restaging, a clear tendency of decreased recurrence‐free survival (RFS) and overall survival (OS) with increasing stage was observed. Multivariate Cox analysis showed that 2018 FIGO stage, parametrial involvement, and histology were independent prognostic factors for both OS and RFS (P < 0.05). Based on these factors, we established predictive nomograms with c‐indexes of 0.735 and 0.721, showing good predictive ability for cervical cancer. Conclusion The revised 2018 FIGO staging system can better reflect the survival of cervical cancer patients. Based on it, we established a nomogram that can predict the prognosis of cervical cancer patients more precisely.

show abstract

Section: Introductionmentioning

confidence: 99%

A novel prognostic nomogram utilizing the 2018 FIGO staging system for cervical cancer: A large multicenter study

Tang

Guo

Liu

et al. 2021

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…Since the revised staging system was released, several studies have validated the new staging system 2, 11–13 . However, there are few reports on the stage IB1 patients in the FIGO 2009 staging system who are down‐staged to stage IA disease in the FIGO 2018 classification 12 .…”

Section: Discussionmentioning

confidence: 99%

“…The revised FIGO staging system allows imaging and pathological findings, where available, to determine the stage. 1 The main changes in the FIGO 2018 staging system compared with the FIGO 2009 system are as follows: (1) for stage IA disease, the horizontal dimension is no longer considered: (2) for stage IB disease, the substages have been revised with respect to dimensions in tumor size (stage IB1: stromal invasion depth of ≥5 mm and <2 cm in the greatest dimension, stage IB2: ≥2 cm and <4 cm in the greatest dimension, stage IB3: ≥4 cm in the greatest dimension); and (3) the involvement of lymph nodes according to either imaging (r) or pathology (p) has been described as a new substage, stage IIIC (stage IIIC1: pelvic lymph node metastasis only, stage IIIC2: para-aortic lymph node metastasis). 1,2 According to the National Comprehensive Cancer Network (NCCN) guidelines, 3 radical hysterectomy or radiotherapy is recommended for stage IB1 disease.…”

Section: Introductionmentioning

confidence: 99%

“…1 The main changes in the FIGO 2018 staging system compared with the FIGO 2009 system are as follows: (1) for stage IA disease, the horizontal dimension is no longer considered: (2) for stage IB disease, the substages have been revised with respect to dimensions in tumor size (stage IB1: stromal invasion depth of ≥5 mm and <2 cm in the greatest dimension, stage IB2: ≥2 cm and <4 cm in the greatest dimension, stage IB3: ≥4 cm in the greatest dimension); and (3) the involvement of lymph nodes according to either imaging (r) or pathology (p) has been described as a new substage, stage IIIC (stage IIIC1: pelvic lymph node metastasis only, stage IIIC2: para-aortic lymph node metastasis). 1,2 According to the National Comprehensive Cancer Network (NCCN) guidelines, 3 radical hysterectomy or radiotherapy is recommended for stage IB1 disease. Complications are more intense after radical hysterectomy than after simple extrafascial hysterectomy or modified radical hysterectomy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Validation of the FIGO 2018 staging system of cervical cancer: Retrospective analysis of FIGO 2009 stage IB1 cervical cancer with tumor under 2 cm

Takahashi

Sakai

Iwasa

et al. 2021

J of Obstet and Gynaecol

View full text Add to dashboard Cite

Aim The International Federation of Gynecology and Obstetrics (FIGO) revised the cervical cancer staging system in 2018. This study aims to validate the revised staging system in patients with tumors <2 cm in size who were classified as FIGO 2009 stage IB1. Methods We evaluated 62 women with stage IB1 cervical cancer (FIGO 2009) who underwent radical hysterectomy as the initial treatment between November 2004 and August 2018 in our institution. The patients with FIGO 2009 stage IB1 and tumors <2 cm in size were enrolled. We reclassified their stage according to the FIGO 2018 staging system and analyzed their clinicopathological data retrospectively. Results Twenty‐five patients met the inclusion criteria. According to the FIGO 2018 classification, 9 (36.0%) patients were classified as stage IA, 13 (52.0%) as stage IB1, and 3 (12.0%) as stage IIIC, respectively. One (11.1%), six (46.2%), and three (100%) patients with lymphovascular space invasion were classified as stage IA, IB1, and IIIC, respectively. No significant differences were found in the 5‐year overall survival or progression‐free survival among the three stages. Conclusions As many as 36.0% of patients classified as FIGO 2009 stage IB1 with a tumor <2 cm in size were classified as stage IA in the FIGO 2018 classification. For these cases, a treatment less invasive than radical hysterectomy or radiotherapy might be sufficient. Our results suggest that cervical cancer patients with tumors <2 cm should be carefully diagnosed by performing cervical conization and assessed the pathological findings before hysterectomy.

show abstract

“…Patients with widowed or single (never married or having a domestic partner) or divorced or separated status were all classified as unmarried 22 , 23 . All of the eligible cases were re-identified according to the 2018 FIGO staging criteria 24 , 25 . Median age at diagnosis was 45 years old in our study, which was used as the cutoff value for age classification.…”

Section: Methodsmentioning

confidence: 99%

Clinicopathological characteristics and prognostic factors of cervical adenocarcinoma

Wang

Yuan

Zhou

et al. 2021

Sci Rep

View full text Add to dashboard Cite

We aimed to assess the clinicopathological features and to determine the prognostic factors of cervical adenocarcinoma (AC). Relevant data were extracted from surveillance, epidemiology and end results database from 2004 to 2015. The log-rank test and Cox proportional hazard analysis were subsequently utilized to identify independent prognostic factors. A total of 3102 patients were identified. The enrolled patients were characterized by higher proportion of early FIGO stage (stage I: 65.9%; stage II: 14.1%), low pathological grade (grade I/II: 49.1%) and tumor size ≤ 4 cm (46.8%). The 5- and 10-year cancer-specific survival rates of these patients were 74.47% and 70.00%, respectively. Meanwhile, the 5- and 10-year overall survival (OS) rates were 71.52% and 65.17%, respectively. Multivariate analysis revealed that married status, surgery as well as chemotherapy were independent favorable prognostic indicators. Additionally, aged > 45, tumor grade III/IV, tumor size > 4 cm, advanced FIGO stage and pelvic lymph node metastasis (LNM) were unfavorable prognostic factors (all P < 0.01). Stratified analysis found that patients without surgery could significantly benefit from chemotherapy and radiotherapy. In addition, chemotherapy could significantly improve the survival in stage II–IV patients and radiotherapy could only improve the survival in stage III patients (all P < 0.01). Marital status, age, grade, tumor size, FIGO stage, surgery, pelvic LNM and chemotherapy were significantly associated with the prognosis of cervical AC.

show abstract

Is the revised 2018 FIGO staging system for cervical cancer more prognostic than the 2009 FIGO staging system for women previously staged as IB disease?

Cited by 24 publications

References 19 publications

A novel prognostic nomogram utilizing the 2018 FIGO staging system for cervical cancer: A large multicenter study

A novel prognostic nomogram utilizing the 2018 FIGO staging system for cervical cancer: A large multicenter study

Validation of the FIGO 2018 staging system of cervical cancer: Retrospective analysis of FIGO 2009 stage IB1 cervical cancer with tumor under 2 cm

Clinicopathological characteristics and prognostic factors of cervical adenocarcinoma

Contact Info

Product

Resources

About