Current classification of malignant tumours in gynecological oncology – part I

Czech version

Authors: B. Sehnal ¹; D. Driák ¹; E. Kmoníčková ²; M. Dvorská ¹; M. Hósová ³; K. Citterbart ¹; M. Halaška ¹; D. Kolařík ¹
Authors‘ workplace: Gynekologicko-porodnická klinika, 1. LF UK a FN Na Bulovce, Praha, přednosta prof. MUDr. M. Halaška, DrSc. ¹; Ústav radiační onkologie, 1. LF UK a FN Na Bulovce, Praha, přednosta prof. MUDr. J. Abrahámová, DrSc. ²; Patologicko-anatomické oddělení, 1. LF UK a FN Na Bulovce, Praha, primářka MUDr. K. Benková ³
Published in: Ceska Gynekol 2011; 76(4): 279-284

Overview

Objective:
Review of new staging systems for gynaecological cancers and their impact on prognosis and planning treatment.

Design:
Review article.

Setting:
Department of Gynaecology and Obstetrics, First Faculty of Medicine and University Hospital Na Bulovce, Charles University, Prague.

Department of Radiotherapeutic Oncology, First Faculty of Medicine and University Hospital Na Bulovce, Charles University, Prague.

Department of Pathology, University Hospital Na Bulovce, Prague.

Results:
The main objectives of any good staging system – essential to an evidence-based approach to cancer – include planning treatment, providing an assessement of prognosis and the evaluation of the results of treatment. With this approach, the exchange of relevant information between oncological centers is facilitated, thus disseminating knowledge and stimulating research in other parts of the world. A good staging system must have three basic characteristics: validity, reliability, and practicality. The first staging system for gynaecological cancers appeared around the turn of the 20th century and was applied to carcinoma of the cervix uteri. Classifications for the other gynaecological malignancies were not created until the 1950s. Over the years, these staging classifications - with the exception of cervical cancer and gestational trophoblastic neoplasia - have shifted from a clinical to a surgical-pathological basis. Some changes, brought about through new findings, were approved by the FIGO in 2008 and published in 2009. The greatest changes were made in the new staging system for carcinoma of the vulva, while others were made in the new staging systems for carcinoma of the cervix and carcinoma of the endometrium. A new stanging system was also created for uterine sarcomas, based on the criteria used in other soft tissue sarcomas.

Conclusion:
As a result of the explosion of medical research in the field of oncology, the staging of some of the gynaecological cancers became outdated and did not give a good spread of prognostic groupings. Therefore, revised FIGO and TNM staging system has been structured to represent major prognostic factors in predicting patients’ outcomes and lending order to the complex dynamic behavior of gynaecological cancers. The purpose of a good staging system is to offer a classification of the extent of gynaecological cancer, in order to provide a method of conveying one’s clinical experience to others for the comparison of different treatment methods.

Key words:
staging, gynaecological oncology, FIGO, TNM.

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