Impact of the new FIGO 2013 classification on prognosis of stage I epithelial ovarian cancers

Abstract

PurposeThe stage of disease is one of the strongest prognostic factors in epithelial ovarian cancer. The International Federation of Gynecology and Obstetrics (FIGO) classification was revised in 2013; stage IC was subdivided into IC1 (intraoperative surgical spill), IC2 (capsule rupture before surgery or tumor on surface), and IC3 (positive peritoneal washing or ascites). Our aim was to compare the outcome of patients in the new FIGO stage I subgroups, as this might influence adjuvant therapy decisions.Patients and methodsPatient databases of three gynecological oncology centers were retrospectively analyzed. Patients with FIGO stage I ovarian cancers were restaged according to the revised classification, based on operative and pathological reports, and determined patient outcomes.ResultsWe analyzed 128 patients with ovarian cancers. In FIGO IA, we found 11.3% recurrences and 4.2% deaths. In FIGO IC, 21.8% of the patients recurred and 7.3% died. There was a trend toward a shorter time to recurrence when comparing IA to IC (P=0.076). Within all new subgroups of FIGO IC, there was no difference in time to recurrence (P=0.59). There was also no significant difference in survival when FIGO IA was compared to FIGO IC in comparison with the new individual classifications (IA to IC, IA to IC1, 2, or 3; P=0.60, P=0.15, P=0.61, P=0.66, respectively) or within the different subgroups (P=0.56). Platinum-based chemotherapy was given to the majority (82.6%, n=38/46) of the FIGO IC patients compared to 30.9% in FIGO IA (n=17/55). There was no significant difference within the new subgroups of FIGO IC (P=0.88).ConclusionIn our retrospective analysis, the new FIGO staging of IC ovarian cancers did not predict prognosis, but the use of adjuvant chemotherapy in 82.6% of the stage IC patients may have biased the outcome.

Intraoperative Rupture of the Ovarian Capsule in Early-Stage Ovarian Cancer

“…Two handsearched articles were also added after a manual search of Google Scholar. 14,15 After duplicate records were removed, we abstracted 1,386 unique citations. Of those screened, 55 observational studies that compared intraoperative ovarian capsule rupture with no rupture were evaluated for inclusion and exclusion criteria.…”

“…Seventeen studies met all the criteria for inclusion in our meta-analysis. 5,7,14,15,[53][54][55][56][57][58][59][60][61][62][63][64][65] The PRISMA flow diagram shows the entire review process from the original search to the final selection (Fig. 1).…”

<p>A Polyethylene Glycol-Based Method for Enrichment of Extracellular Vesicles from Culture Supernatant of Human Ovarian Cancer Cell Line A2780 and Body Fluids of High-Grade Serous Carcinoma Patients</p>

“…Patients were staged according to the International Federation of Obstetrics and Gynecology (FIGO) 2013 staging standard. 35 Stages I-II and stages III-IV were identified in 4 and 6 cases, respectively. The pathological type was HGSC in all patients.…”

Nomogram incorporating log odds of positive lymph nodes improves prognostic prediction for ovarian serous carcinoma: a real-world retrospective cohort study

“…Currently, the International Federation of Gynaecology and Obstetrics (FIGO) staging system is widely used for staging ovarian cancer and assessing patient prognosis 14. However, it is important to recognise that this system has limitations, and its accuracy may be relatively low, potentially resulting in a lack of precise prognostic information 15 16. Additionally, the FIGO staging system may not fully consider important factors such as age, which significantly affect prognosis.…”