Back to Search Start Over

Prognostic Performance of the 2018 International Federation of Gynecology and Obstetrics Cervical Cancer Staging Guidelines.

Authors :
Wright JD
Matsuo K
Huang Y
Tergas AI
Hou JY
Khoury-Collado F
St Clair CM
Ananth CV
Neugut AI
Hershman DL
Source :
Obstetrics and gynecology [Obstet Gynecol] 2019 Jul; Vol. 134 (1), pp. 49-57.
Publication Year :
2019

Abstract

Objective: To examine the prognostic performance of the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) cervical cancer staging schema.<br />Methods: We used the National Cancer Database to identify women with cervical cancer diagnosed from 2004 to 2015. Using clinical and pathologic data, each patient's stage was classified using three staging schemas: American Joint Committee on Cancer 7th edition, FIGO 2009 and FIGO 2018. The FIGO 2018 revised staging classifies stage IB tumors into three substages based on tumor size (IB1-IB3) and classifies patients with positive lymph nodes (pathologically or clinically detected) as stage IIIC1 (positive pelvic nodes) or IIIC2 (positive para-aortic nodes). Five-year survival rates were estimated for each stage grouping. We sought to determine whether the 2018 FIGO staging system was able to offer improved 5-year survival rate differentiation compared with older staging schemas.<br />Results: A total of 62,212 women were identified. The classification of stage IB tumors into three substages improved discriminatory ability. Five-year survival in the FIGO 2018 schema was 91.6% (95% CI 90.4-92.6%) for stage IB1 tumors, 83.3% (95% CI 81.8-84.8%) for stage IB2 neoplasms, and 76.1% (95% CI 74.3-77.8%) for IB3 lesions. In contrast, for women with stage III tumors, higher FIGO staging was not consistently associated with worse 5-year survival rates: stage IIIA (40.7%, 95 CI 37.1-44.3%), stage IIIB (41.4%; 95% CI 39.9-42.9%), stage IIIC1 (positive pelvic nodes) was 60.8% (95% CI 58.7-62.8%) and stage IIIC2 37.5% (95% CI 33.3-41.7%).<br />Conclusion: The FIGO 2018 staging schema provides improved discriminatory ability for women with stage IB tumors; however, classification of all women with positive lymph nodes into a single stage results in a very heterogeneous group of patients with highly variable survival rates.

Details

Language :
English
ISSN :
1873-233X
Volume :
134
Issue :
1
Database :
MEDLINE
Journal :
Obstetrics and gynecology
Publication Type :
Academic Journal
Accession number :
31188324
Full Text :
https://doi.org/10.1097/AOG.0000000000003311