#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Current FIGO Staging for Carcinoma of the Cervix Uteri and Treatment of Particular Stages


Authors: B. Sehnal 1;  E. Kmoníčková 2;  J. Sláma 3;  V. Tomancová 2;  Michal Zikán 1
Authors place of work: Onkogynekologické centrum, Gynekologicko-porodnická klinika 1. LF UK a Nemocnice Na Bulovce, Praha 1;  Ústav radiační onkologie, Komplexní onkologické centrum, Nemocnice Na Bulovce, Praha 2;  Onkogynekologické centrum, Gynekologicko-porodnická klinika 1. LF UK a VFN, Praha 3
Published in the journal: Klin Onkol 2019; 32(3): 224-231
Category: Short Communication
doi: https://doi.org/10.14735/amko2019224

Summary

Background: Here, we present a review of the revised FIGO (International Federation of Gynecology and Obstetrics) staging system for carcinoma of the cervix uteri, explaining the reasons for the changes and summarizing suitable diagnostic methods and treatment options for particular stages of disease according to current guidelines.

Aim: The FIGO staging system has been revised as follows. Measurement of lateral extension has been removed from stage IA; the only criterion is a measurement for the deepest invasion of < 5.0 mm. Stage IB has been divided into three subgroups: IB1, tumors with a largest diameter measuring ≥ 5 mm and < 2 cm; IB2, tumors measuring 2–4 cm; IB3, tumors measuring ≥ 4 cm. Stage IIIC includes an assessment of retroperitoneal lymph nodes: IIIC1 if only pelvic lymph nodes are involved, and IIIC2 if para-aortic nodes are infiltrated. The revised staging system does not mandate the use of a specific imaging method or surgical assessment of the extent of the tumor. The method used to assign a stage should be recorded and reported. The European Society of Gynaecological Oncology, the European Society for Radiotherapy and Oncology, and the European Society of Pathology have developed clinically relevant and evidence-based guidelines to improve the quality of care for women with cervical cancer. These guidelines cover comprehensive staging, management, and follow-up for patients with cervical cancer. The guidelines are intended for use by gynaecologic oncologists, general gynaecologists, surgeons, radiation oncologists, pathologists, clinical oncologists, radiologists, general practitioners, palliative care experts, and other health professionals.

Conclusion: We summarize the new FIGO classification system, including diagnostic methods and treatments for particular stages. We also discuss the main changes and their clinical impact.

This work was supported by the Charles University project UNCE 204065.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.

Keywords:

guidelines – cancer staging – cancer of the cervix uteri – FIGO staging – gynecological cancer


Zdroje

1. Bray F, Ferlay J, Soerjomataram I et al. Global cancer statistics 2018: GLOBOCAN estimates of cancer incidence and mortality for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68 (6): 394–424. doi: 10.3322/caac.21 492.

2. Svod.cz. Epidemiologie zhoubných nádorů v České republice. [online]. Dostupné z: www.svod.cz.

3. Kinkorová Luňáčková IK, Májek O. Karcinom děložního hrdla v ČR a možnosti jeho prevence. Cesk Patol 2018; 63 (4): 164–168.

4. Sláma J. Současné limity prevence karcinomu děložního hrdla v České republice. Ceska Gynekol 2017; 82 (6): 482–486.

5. Bhatla N, Berek JS, Cuello Fredes M et al. Revised FIGO staging for carcinoma of the cervix uteri. Int J Gynaecol Obstet 2019; 145 (1): 129–135. doi: 10.1002/ijgo.12 749.

6. Cibula D, Pötter R, Planchamp F 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 (3): 404–416. doi: 10.1016/j.radonc.2018.03.003.

7. Baiocchi G, de Brot L, Faloppa CC et al. Is parametrectomy always necessary in early-stage cervical cancer? Gynecol Oncol 2017; 146 (1): 16–19. doi: 10.1016/j.ygyno.2017.03.514.

8. Kodama J, Fukushima C, Kusumoto T et al. Stage IB1 cervical cancer patients with an MRI-measured tumor size < or = 2 cm might be candidates for less-radical surgery. Eur J Gynaecol Oncol 2013; 34 (1): 39–41.

9. Rob L, Charvat M, Robova H et al. Less radical fertility-sparing surgery than radical trachelectomy in early cervical cancer. Int J Gynecol Cancer 2007; 17 (1): 304–310. doi: 10.1111/j.1525-1438.2007.00758.x.

10. Sláma J, Černý A, Dušek L et al. Results of less radical fertility-sparing procedures with omitted parametrectomy for cervical cancer: 5 years of experience. Gynecol Oncol 2016; 142 (3): 401–404. doi: 10.1016/j.ygyno.2016.07.008.

11. Querleu D, Cibula D, Abu-Rustum NR. 2017 update on the Querleu-Morrow classification of radical hysterectomy. Ann Surg Oncol 2017; 24 (11): 3406–3412. doi: 10.1245/s10434-017-6031-z.

12. Šišovská I, Minář L, Felsinger M et al. Novinky ve FIGO stagingu karcinomu ovaria, tuby a peritonea. Ceska Gynekol 2017; 82 (3): 230–236.

13. Sehnal B, Driák D, Kmoníčková E et al. Současná klasifikace zhoubných nádorů v onkogynekologii – část I. Ceska Gynekol 2011; 76 (4): 279–284.

14. Fischerová D. Staging zhoubného nádoru děložního hrdla (stanovení předoperačního rozsahu onemocnění) – přehled výsledků nejnovějších ultrazvukových studií. Ceska Gynekol 2014; 79 (6): 436–446.

15. Balleyguier C, Sala E, Da Cunha T et al. Staging of uterine cervical cancer with MRI: guidelines of the European Society of Urogenital Radiology. Eur Radiol 2011; 21 (5): 1102–1110. doi: 10.1007/s00330-010-1998-x.

16. Fischerova D, Cibula D, Stenhova H et al. Transectal ultrasound and magnetic resonance imaging in staging of early cervical cancer. Int J Gynecol Cancer 2008; 18 (4): 766–772. doi: 10.1111/j.1525-1438.2007.01 072.x.

17. Epstein E, Testa A, Gaurilcikas A et al. Early-stage cervical cancer: tumor delineation by magnetic resonance imaging and ultrasound – an European multicenter trial. Gynecol Oncol 2013; 128 (3): 449–453. doi: 10.1016/j.ygyno.2012.09.025.

18. Testa AC, Ludovisi M, Manfredi R et al. Transvaginal ultrasonography and magnetic resonance imaging for assessment of presence, size and extent of invasive cervical cancer. Ultrasound Obstet Gynecol 2009; 34 (3): 335–344. doi: 10.1002/uog.7325.

19. Gong Y, Wang Q, Dong L et al. Different imaging techniques for the detection of pelvic lymph nodes metastasis from gynecological malignancies: a systematic review and meta-analysis. Oncotarget 2017; 8 (8): 14107–14125. doi: 10.18632/oncotarget.12959.

20. Fischerova D, Cibula D. Role ultrazvuku ve stagingu zhoubného nádoru děložního hrdla (doporučení Evropské onkologické, radiační, a patologické společnosti). Čes Gynek 2019; 84 (1): 40–48.

21. Tsunoda AT, Marnitz S, Soares Nunes J et al. Incidence of histologically proven pelvic and para-aortic lymph node metastases and rate of upstaging in patients with locally advanced cervical cancer: results of a prospective randomized trial. Oncology 2017; 92 (4): 213–220. doi: 10.1159/000453666.

22. Zikán, M. Volba vhodné bioptické metody u primárně inoperabilního nebo recidivujícího zhoubného nádoru a metodika bioptického odběru. Ceska Gynekol 2014; 79 (6): 487–490.

23. Weinberger V, Dvořak M, Haakova L et al. Ultrazvukový staging karcinomu děložního hrdla – návrh standardního postupu. Ceska Gynekol 2014; 79 (6): 447–455.

24. Cibula D, McCluggage WG. Sentinel lymph node (SLN) concept in cervical cancer: Current limitations and unanswered questions. Gynecol Oncol 2019; 152 (1): 202–207. doi: 10.1016/j.ygyno.2018.10.007.

Štítky
Paediatric clinical oncology Surgery Clinical oncology

Článok vyšiel v časopise

Clinical Oncology

Číslo 3

2019 Číslo 3
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#