Revised FIGO staging for carcinoma of the cervix uteri

Abstract

Objective To revise FIGO staging of carcinoma of the cervix uteri, allowing incorporation of imaging and/or pathological findings, and clinical assessment of tumor size and disease extent. Methods Review of literature and consensus view of the FIGO Gynecologic Oncology Committee and related societies and organizations. Results In stage I, revision of the definition of microinvasion and lesion size as follows. Stage IA: lateral extension measurement is removed; stage IB has three subgroups—stage IB1: invasive carcinomas ≥5 mm and <2 cm in greatest diameter; stage IB2: tumors 2–4 cm; stage IB3: tumors ≥4 cm. Imaging or pathology findings may be used to assess retroperitoneal lymph nodes; if metastatic, the case is assigned stage IIIC; if only pelvic lymph nodes, the case is assigned stage IIIC1; if para‐aortic nodes are involved, the case is assigned stage IIIC2. Notations ‘r’ and ‘p’ will indicate the method used to derive the stage—i.e., imaging or pathology, respectively—and should be recorded. Routine investigations and other methods (e.g., examination under anesthesia, cystoscopy, proctoscopy, etc.) are not mandatory and are to be recommended based on clinical findings and standard of care. Conclusion The revised cervical cancer staging is applicable to all resource levels. Data collection and publication will inform future revisions.

Analysis of isolated loco-regional recurrence rate in intermediate risk early cervical cancer after a type C2 radical hysterectomy without adjuvant radiotherapy

“…In the most recent FIGO Committee Report a change from clinical staging to clinical/imaging/pathological based staging for cervical cancer was announced 8. In a previously published,9 FIGO Cancer Report 2018, treatment recommendations were also given.…”

SEOM clinical guidelines for cervical cancer (2019)

“…The main changes incorporated were the following: use of any imaging modality and/or pathological findings for allocating the stage; in stage IA the width of the lesion is no longer taken into consideration; stage IB now includes three subgroups as the tumor size increases 2 cm: stage IB1 (< 2 cm), stage IB2 disease (2 to < 4 cm), and stage IB3 (≥ 4 cm). The most relevant modification was the introduction of the lymph node (LN) status, indeed, the LN involvement (via histologic or radiologic assessment) was specifically designated as stage IIIC (IIIC1 pelvic LN metastasis, and IIIC2 para-aortic LN metastasis) ( Table 1) [5].…”

Predictive Role of MRI and 18F FDG PET Response to Concurrent Chemoradiation in T2b Cervical Cancer on Clinical Outcome: A Retrospective Single Center Study

“…Cervical carcinoma (CC) is the third commonest gynecological cancer in women worldwide [1,2]. In the past, CC was routinely staged with the clinical FIGO system but the new ESGO guidelines introduced and recommended a TNM classification with a FIGO staging, too [3][4][5]. Early CC and locally advanced CC (LACC) represent two different realities with distinct therapeutic approaches and prognosis.…”