Validation of the 2018 FIGO Staging System for Predicting the Prognosis of Patients With Stage IIIC Cervical Cancer

Long, Xingtao; He, Misi; Yang, Lingling; Zou, Dongling; Wang, Dong; Chen, Yuemei; Zhou, Qi

doi:10.1177/11795549221146652

Cited by 6 publications

(7 citation statements)

References 31 publications

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“…The final analysis included a total of 10 retrospective cohort studies. 3,15,16,[22][23][24][25][26][27][28] The PFS group comprised five studies, 15,[23][24][25][26] while the OS group consisted of seven studies. 3,15,16,22,25,27,28 IIIC1 and IIIC2, and directly used stage IIIC instead.…”

Section: Search Results and Description Of Studiesmentioning

confidence: 99%

“…3,15,16,[22][23][24][25][26][27][28] The PFS group comprised five studies, 15,[23][24][25][26] while the OS group consisted of seven studies. 3,15,16,22,25,27,28 IIIC1 and IIIC2, and directly used stage IIIC instead. 15,22,27 To improve the precision of our analytical conclusion, we grouped stages IIIC and IIIC1 together, referred to as IIIC/C1.…”

Section: Search Results and Description Of Studiesmentioning

confidence: 99%

“…Overall NOS scores ranged from 5 to 9 points (Table S1). The data were collected from China, 15,16,24 the United States, 3,22,23 Denmark, 27,28 Japan, 25 and South Korea. 26 However, there was a possibility of patient overlap across different databases within the same country.…”

Section: Risk Of Biasmentioning

confidence: 99%

“…5,6 Since the introduction of 2018 FIGO staging system, there have been increasing concerns regarding the reliability of 2018 FIGO stage IIIC due to considerable heterogeneity in classifying lymph node metastases, regardless of tumor size or number of nodal metastases. [14][15][16][17][18][19] For example, a study from National Cancer Database (NCDB) reported that the 5-year survival rates of FIGO 2018 stages IA, IB, II, and III were 94%, 86.3%, 66.9%, and 47.7%, respectively. The 5-year survival rate of stage IIIC1 was 61.9%, while the 5-year survival rates of IIIC1 with T1a, T1b, T2 and T3 stages were 95.8%, 80.3%, 57.2%, and 39.7%, respectively.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, the presence of metastasis in para‐aortic lymph nodes is associated with a poorer prognosis compared with isolated pelvic lymph node involvement 5,6 . Since the introduction of 2018 FIGO staging system, there have been increasing concerns regarding the reliability of 2018 FIGO stage IIIC due to considerable heterogeneity in classifying lymph node metastases, regardless of tumor size or number of nodal metastases 14–19 . For example, a study from National Cancer Database (NCDB) reported that the 5‐year survival rates of FIGO 2018 stages IA, IB, II, and III were 94%, 86.3%, 66.9%, and 47.7%, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Survival outcomes of 2018 FIGO stage IIIC versus stages IIIA and IIIB in cervical cancer: A systematic review with meta‐analysis

Zhang,

Wang,

Zhao

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo assess the difference in survival outcomes between stage IIIC and stages IIIA and IIIB in the 2018 FIGO cervical cancer staging system.MethodsThe PubMed, EMBASE, MEDLINE and Web of Science were searched for articles published from November 1, 2018 to January 31, 2023. Articles published in English were considered. The included studies compared the survival outcomes of patients with cervical cancer in FIGO 2018 stage IIIC with those in stages IIIA and IIIB. Studies focused on rare histopathological types were excluded. The statistical analyses were performed using Stata 17 software. The endpoints were overall survival (OS) and progression‐free survival (PFS).ResultsTen retrospective cohort studies were eligible, involving 2113 (6.2%), 9812 (28.6%), 44 (0.1%), 10 171 (29.7%), 11 677 (34.1%) and 445 (1.3%) patients in stage IIIA, IIIB, IIIA&B, IIIC, IIIC1, and IIIC2, respectively. In the OS group, stage IIIC/C1 was significantly associated with superior survival compared with stage IIIA (hazard risk [HR] 0.62, 95% confidence interval [CI] 0.41–0.93, P = 0.022; I2 = 92.9%) and stage IIIB(A&B) (HR 0.56, 95% CI 0.44–0.71, P < 0.001; I2 = 94.0%). The FIGO 2018 stage IIIC2 was not associated with an increased mortality risk compared with stage IIIA and stage IIIB(A&B). In the PFS group, the outcome of FIGO 2018 stage IIIC/C1 was similar to stage IIIA (HR 0.66, 95% CI 0.27–1.64, P = 0.371; I2 = 65.6%), but better than stage IIIB(A&B) (HR 0.75, 95% CI 0.68–0.83, P < 0.001; I2 = 0.0%). The FIGO 2018 stage IIIC2 has similar PFS outcomes to stage IIIA and stage IIIB(A&B).ConclusionOur findings demonstrate that survival outcomes of stage IIIC are no worse than those of stage IIIA and stage IIIB in the 2018 FIGO cervical cancer staging system. In cervical cancer, FIGO 2018 stage IIIC1 has significantly better OS outcomes than stage IIIA and stage IIIB.

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