Comparing survival outcomes for cervical cancer based on the 2014 and 2018 International Federation of Gynecology and Obstetrics staging systems

Wonkyo Shin, Tae Young Ham, Young Ran Park, Myong Cheol Lim, Young-Joo Won, Wonkyo Shin, Tae Young Ham, Young Ran Park, Myong Cheol Lim, Young-Joo Won

Abstract

The International Federation of Gynecology and Obstetrics (FIGO) cervical cancer staging system was modified in 2018, introducing new stage IB subdivisions and new lymph node status considerations in stage IIIC. We compared cervical cancer survival outcomes according to the 2014 and 2018 FIGO staging systems. We selected 10% of cervical cancer cases (2010-2015) from the Korean national cancer registry (2010-2015) through a systematic sampling method. We collected information using a collaborative stage data collection system and evaluated the results according to both staging systems. The log-rank test was used to analyze overall survival differences. No significant difference in survival was observed between 2018 subdivisions IB1/IB2/IB3 (P = 0.069), whereas a considerable difference was observed between these subdivisions according to histological subtypes. In the 2018 FIGO staging system, stage IIIC had better survival than stage IIIA/IIIB (P < 0.001). We observed considerable heterogeneity in 2018 stage IIIC related to the corresponding stages of the 2014 staging system (stages IA1-IIIB). The size of the primary cervical mass was related to survival (P < 0.001). In conclusion, using lymph node status to define stage IIIC captured a broad range of prognoses. The inclusion of primary tumor size considerations may improve the staging accuracy of advanced cervical cancer.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Kaplan–Meier analysis of survival for 2018 FIGO stages IB1/IB2/IB3.
Figure 2
Figure 2
Kaplan–Meier analysis of survival for 2018 FIGO stage III.
Figure 3
Figure 3
Distribution of 2014 FIGO stages in the 2018 FIGO stages IIIC1 (a) and IIIC2 (b).

References

    1. Koh WJ, et al. Cervical cancer, version 3.2019, NCCN clinical practice guidelines in oncology. J. Natl. Compr. Cancer Netw. 2019;17:64–84. doi: 10.6004/jnccn.2019.0001.
    1. Koh WJ, et al. Uterine Neoplasms, version 1.2018, NCCN clinical practice guidelines in oncology. J. Natl. Compr. Cancer Netw. 2018;16:170–199. doi: 10.6004/jnccn.2018.0006.
    1. Morgan RJ, Jr, et al. Ovarian cancer, version 1.2016, NCCN clinical practice guidelines in oncology. J. Natl. Compr. Cancer Netw. 2016;14:1134–1163. doi: 10.6004/jnccn.2016.0122.
    1. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int. J. Gynaecol. Obstet. 2009;105:103–104. doi: 10.1016/j.ijgo.2009.02.012.
    1. Pecorelli S, Zigliani L, Odicino F. Revised FIGO staging for carcinoma of the cervix. Int. J. Gynaecol. Obstet. 2009;105:107–108. doi: 10.1016/j.ijgo.2009.02.009.
    1. Figo Committee on Gynecologic Oncology FIGO staging for carcinoma of the vulva, cervix, and corpus uteri. Int. J. Gynaecol. Obstet. 2014;125:97–98. doi: 10.1016/j.ijgo.2014.02.003.
    1. Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int. J. Gynaecol. Obstet. 2018;143(Suppl 2):22–36. doi: 10.1002/ijgo.12611.
    1. Cohen PA, Jhingran A, Oaknin A, Denny L. Cervical cancer. Lancet. 2019;393:169–182. doi: 10.1016/S0140-6736(18)32470-X.
    1. Del Carmen MG, et al. Isolated para-aortic lymph node metastasis in FIGO stage IA2-IB2 carcinoma of the cervix: Revisiting the role of surgical assessment. Gynecol. Oncol. 2018;150:406–411. doi: 10.1016/j.ygyno.2018.07.010.
    1. Negrao MV, Lima JM, Silva SC, Diz MD, da Costa Miranda V. Management of para-aortic lymph node disease in patients with cervical cancer: What is the best approach? Int. J. Gynecol. Cancer. 2017;27:543–549. doi: 10.1097/IGC.0000000000000914.
    1. Ramirez PT, et al. Minimally invasive versus abdominal radical hysterectomy for cervical cancer. N. Engl. J. Med. 2018;379:1895–1904. doi: 10.1056/NEJMoa1806395.
    1. Cibula D, et al. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. Virchows Arch. 2018;472:919–936. doi: 10.1007/s00428-018-2362-9.
    1. Matsuo K, Machida H, Mandelbaum RS, Konishi I, Mikami M. Validation of the 2018 FIGO cervical cancer staging system. Gynecol. Oncol. 2019;152:87–93. doi: 10.1016/j.ygyno.2018.10.026.
    1. Somashekhar SP, Ashwin KR. Management of early stage cervical cancer. Rev. Recent Clin. Trials. 2015;10:302–308. doi: 10.2174/1574887110666150923113629.
    1. Kim SI, et al. Comparison of survival outcomes between minimally invasive surgery and conventional open surgery for radical hysterectomy as primary treatment in patients with stage IB1-IIA2 cervical cancer. Gynecol. Oncol. 2019;153:3–12. doi: 10.1016/j.ygyno.2019.01.008.
    1. Leitao MM., Jr The LACC Trial: Has minimally invasive surgery for early-stage cervical cancer been dealt a knockout punch? Int. J. Gynecol. Cancer. 2018;28:1248–1250. doi: 10.1097/IGC.0000000000001342.
    1. Cibula D, et al. New classification system of radical hysterectomy: Emphasis on a three-dimensional anatomic template for parametrial resection. Gynecol. Oncol. 2011;122:264–268. doi: 10.1016/j.ygyno.2011.04.029.
    1. Querleu D, Morrow CP. Classification of radical hysterectomy. Lancet Oncol. 2008;9:297–303. doi: 10.1016/S1470-2045(08)70074-3.
    1. Drescher CW, Hopkins MP, Roberts JA. Comparison of the pattern of metastatic spread of squamous cell cancer and adenocarcinoma of the uterine cervix. Gynecol. Oncol. 1989;33:340–343. doi: 10.1016/0090-8258(89)90524-6.
    1. Green J, et al. Risk factors for adenocarcinoma and squamous cell carcinoma of the cervix in women aged 20–44 years: The UK National Case-Control Study of Cervical Cancer. Br. J. Cancer. 2003;89:2078–2086. doi: 10.1038/sj.bjc.6601296.
    1. Gien LT, Beauchemin MC, Thomas G. Adenocarcinoma: A unique cervical cancer. Gynecol. Oncol. 2010;116:140–146. doi: 10.1016/j.ygyno.2009.09.040.
    1. Pan X, et al. Does adenocarcinoma have a worse prognosis than squamous cell carcinoma in patients with cervical cancer? A real-world study with a propensity score matching analysis. J. Gynecol. Oncol. 2020;31:e80. doi: 10.3802/jgo.2020.31.e80.
    1. Bhatla N, Berek J, Cuello Fredes M, Denny L, Grenman S. Corrigendum to revised FIGO staging for carcinoma of the cervix uteri. Int. J. Gynaecol. Obstet. 2019;145:129–135. doi: 10.1002/ijgo.12749.
    1. Cibula D, et al. The European Society of Gynaecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology guidelines for the management of patients with cervical cancer. Radiother. Oncol. 2018;127:404–416. doi: 10.1016/j.radonc.2018.03.003.
    1. Collaborative Stage Data Collection System Version 02.02 [Internet]. American Joint Committee on Cancer; c2010]. .

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する