The changes in FIGO staging for carcinoma of the cervix uteri

Czech version

Authors: B. Sehnal ¹; J. Sláma ²; E. Kmoníčková ³; O. Dubová ¹; Michal Zikán ¹
Authors‘ workplace: Onkogynekologické centrum, Gynekologicko-porodnická klinika, Nemocnice Na Bulovce a 1. lékařské fakulty Univerzity Karlovy, Praha, přednosta prof. MUDr. M. Zikán, Ph. D. ¹; Onkogynekologické centrum, Gynekologicko-porodnická klinika Všeobecné fakultní nemocnice a 1. lékařské fakulty Univerzity Karlovy, Praha, přednosta prof. MUDr. A. Martan, DrSc. ²; Ústav radiační onkologie, Komplexní onkologické centrum, Nemocnice Na Bulovce, Praha, přednosta prof. MUDr. L. Petruželka, CSc ³
Published in: Ceska Gynekol 2019; 84(3): 216-221
Category:

Overview

Introduction: The carcinoma of the cervix uteri is the fourth most common cancer in women worldwide and more than 85% of these cases occur in developing countries. Altogether 822 new cases were found in the Czech Republic during 2016 which means the incidence 15,3 new diseases/100,000 women.

Objective: To provide an overview of changes in FIGO (International Federation of Gynecology and Obstetrics) staging for carcinoma of the cervix uteri with an incorporation of possible imaging methods and/or pathological findings, and clinical assessment of tumor size and extent.

Settings: Gynecologic Oncology Center, Department of Gynecology and Obstetrics, Hospital Na Bulovce and 1st Medical School of Charles University, Prague; Gynecologic Oncology Center, Department of Gynecology and Obstetrics, General Faculty Hospital and 1st Medical School of Charles University, Prague; Institute of Radiation Oncology, Hospital Na Bulovce, Prague.

Methods: For this review, we have used the results of studies, review articles, and guidelines of oncogynecologic organisations on the cervical cancer published in English. They were identified through a search of literature using PubMed, MEDLINE-Ovid, Scopus and Cochrane Library with the keywords. We summarize the new classification, main changes compared to the former one and their clinical impact.

Conclusion: Lateral extension measurement is removed in the stage IA, the only criterion is the measured deepest invasion <5.0 mm. Stage IB was divided into three subgroups; IB1: tumors ≥5 mm and <2 cm in greatest diameter; IB2: tumors size 2–4 cm; IB3: tumors ≥4 cm. Stage IIIC includes an assessment of retroperitoneal lymph nodes; IIIC1 if only pelvic lymph nodes are involved, IIIC2 if paraaortic nodes are infiltrated. The revised staging system does not mandate the use of a specific imaging method, lymph node biopsy, or surgical assessment of the extent of tumor. The way of assigning the stage should be recorded and reported. The presence of lymphovascular space invasion does not change the stage of a disease.

Keywords:

staging – FIGO – cervix uteri – ESGO

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