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Validation of the 2018 FIGO cervical cancer staging system.

ABSTRACT: OBJECTIVE:To validate the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer, with a particular focus on stage IB and stage III disease. METHODS:Two retrospective cohort studies were conducted using The Surveillance, Epidemiology, and End Results Program between 1988 and 2014. The stage IB cohort consisted of node-negative FIGO stage IB1 (tumor size <2?cm), IB2 (2-3.9?cm), and IB3 (?4?cm) cervical cancer. The stage III cohort consisted of FIGO stage IIIA, IIIB, and stage IIIC1 (any pelvic nodal metastasis) cervical cancer. Multivariable analysis was performed for cause-specific survival based on cancer stage. RESULTS:In the stage IB cohort (n?=?8909), stage IB1 tumors were more likely to be adenocarcinoma and low-grade compared to other the groups (P?

SUBMITTER: Matsuo K

PROVIDER: S-EPMC7528458 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Validation of the 2018 FIGO cervical cancer staging system.

Matsuo Koji K Machida Hiroko H Mandelbaum Rachel S RS Konishi Ikuo I Mikami Mikio M

Gynecologic oncology 20181030 1

<h4>Objective</h4>To validate the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer, with a particular focus on stage IB and stage III disease.<h4>Methods</h4>Two retrospective cohort studies were conducted using The Surveillance, Epidemiology, and End Results Program between 1988 and 2014. The stage IB cohort consisted of node-negative FIGO stage IB1 (tumor size <2 cm), IB2 (2-3.9 cm), and IB3 (≥4 cm) cervical cancer. The stage III coho ...[more]

PMID: 30389105

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Project description:BackgroundIn 2018, a revised staging system was released for cervical cancer, which defined pelvic and paraaortic lymph node metastasis as stages IIIC1 and IIIC2, respectively. In this study, we constructed and validated nomograms to predict the 3- and 5-year survival of patients with cervical cancer based on the revised International Federation of Gynecology and Obstetrics (FIGO) staging system.MethodsWe retrospectively examined patients with 2009 FIGO stage IB-IVA cervical cancer who were treated at our institute between 2011 and 2015. Patients were randomized into the model development and validation cohorts (2:1). Univariate and multivariate analyses were conducted for the model development cohort to identify prognostic factors. In the multivariate analysis, nomograms were built to predict overall survival (OS) and disease-free survival (DFS) using significant variables. The nomograms were assessed based on the discrimination and calibration in both cohorts. Discrimination was assessed using the concordance index. Calibration was performed by comparing the mean nomogram estimated survival and the mean observed survival.ResultsWe included 1,192 patients, with 795 and 397 patients in the model development and validation cohorts, respectively. In the model development cohort, the median follow-up period was 49.2 months. After multivariate analysis, age, histology, 2018 FIGO stage, and pelvic lymph node number were independent factors for OS. Histology, 2018 FIGO stage, squamous cell carcinoma antigen, and pelvic lymph node number were significant predictors of DFS. The nomograms constructed to predict OS and DFS were based on these factors. In both model cohorts, the concordance index for the nomogram-predicted OS and DFS was 0.78 and 0.75 and 0.74 and 0.67, respectively. The calibration curve revealed good agreement between the nomogram predictions and actual values.ConclusionWe constructed robust nomograms to predict the OS and DFS of patients with cervical cancer undergoing treatment with concurrent chemoradiotherapy based on the 2018 FIGO staging system.

Project description:ObjectiveThis study aimed to explore the prognostic factors and outcomes of patients with neuroendocrine tumors (NETs) of the cervix and to determine appropriate treatment.MethodsA single-institution retrospective analysis of 172 patients with NETs was performed based on the new International Federation of Gynecology and Obstetrics (FIGO 2018) staging system.ResultsAmong the 172 eligible patients, 161 were diagnosed with small cell neuroendocrine carcinoma (SCNEC), six with large cell neuroendocrine carcinoma, four with typical carcinoid tumors and one with SCNEC combined with an atypical carcinoid tumor. According to the FIGO 2018 staging guidelines, 31 were stage I, 66 were stage II, 57 were stage III, and 18 were stage IV. The 5-year survival rates of patients with stage I-IV disease were 74.8%, 56.2%, 41.4% and 0%, respectively. The 5-year progression-free survival rates of patients with stage I-IV disease were 63.8%, 54.5%, 30.8% and 0%, respectively. In the multivariate analysis, advanced FIGO stage, large tumor and older age were identified as independent variables for 5-year survival in patients with stage I-IV disease. FIGO stage, tumor size and para-aortic lymph node metastasis were independent prognostic factors for 5-year progression-free survival in patients with stage I-IV disease. For the patients receiving surgery (n = 108), tumor size and pelvic lymph node metastasis were independent prognostic factors for 5-year survival, and pelvic lymph node metastasis for 5-year progression-free survival. In stage IVB, at least six cycles of chemotherapy (n = 7) was associated with significantly better 2-year OS (83.3% vs. 9.1%, p < 0.001) and 2-year PFS (57.1% vs. 0%, p = 0.01) than fewer than six cycles of chemotherapy(n = 11).ConclusionAdvanced FIGO stage, large tumor, older age and lymph node metastasis are independent prognostic factors for NETs of the cervix. The TP/TC and EP regimens were the most commonly used regimens, with similar efficacies and toxicities. Standardized and complete multimodality treatment may improve the survival of patients with NETs.

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Validation of the 2018 FIGO cervical cancer staging system.

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Validation of the 2018 FIGO cervical cancer staging system.

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