Validation of the <scp>FIGO</scp> 2018 staging system of cervical cancer: Retrospective analysis of <scp>FIGO</scp> 2009 stage <scp>IB1</scp> cervical cancer with tumor under 2 cm

Takahashi, M.; Sakai, Kensuke; Iwasa, Naomi; Wada, Mitsuru; Hino, Makiko; Kurahashi, Takashi; Ueno, Mari; Nakagawa, Hiroyuki

doi:10.1111/jog.14713

Cited by 5 publications

(7 citation statements)

References 19 publications

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“…Heterogeneity in the previous IB1 has also been examined in a Japanese study. In this study 36.0% (n = 9) of the patients with 2009 IB1 were classified as FIGO 2018 IA according to the revised classification [8]. In comparison we found that 31.9% of 2009 IB1 patients were downstaged to 2018 IA1 and IA2 due to the removal of horizontal spread in FIGO 2018 IA.…”

Section: Tablementioning

confidence: 55%

“…The treatment suggested by Bhatla et al [3] for 2018 IA1 who are LVSI negative is complete conization only. The Japanese study by Takahashi et al investigated the survival of 2009 IB1 patients with tumor <2 cm and noted that a less invasive treatment than hysterectomy and radiotherapy should suffice for IA tumors [8]. This led us to question if this subgroup of 2009 IB1 patients had been overtreated.…”

Section: Tablementioning

confidence: 99%

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Prognostic value of the 2018 FIGO staging system for cervical cancer

Mohamud

Høgdall

Schnack

2022

Gynecologic Oncology

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Section: Tablementioning

confidence: 55%

Section: Tablementioning

confidence: 99%

Prognostic value of the 2018 FIGO staging system for cervical cancer

Mohamud

Høgdall

Schnack

2022

Gynecologic Oncology

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“…Even if the tumor is larger than 2 cm, when the tumor is exophytic and presumed to have shallowly invaded the stroma by MRI, we should consider that diagnostic conization is necessary to judge the patient’s eligibility for trachelectomy. Takahashi et al [ 16 ] reported that 36.0% of patients classified as FIGO 2009 stage IB1 with tumors measuring <2 cm were reclassified as FIGO 2018 stage IA. The authors suggested that cervical cancer patients with tumors measuring <2 cm should be carefully diagnosed by performing cervical conization before hysterectomy [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Takahashi et al [ 16 ] reported that 36.0% of patients classified as FIGO 2009 stage IB1 with tumors measuring <2 cm were reclassified as FIGO 2018 stage IA. The authors suggested that cervical cancer patients with tumors measuring <2 cm should be carefully diagnosed by performing cervical conization before hysterectomy [ 16 ]. New technology for accurately measuring stromal invasion using MRI is also required.…”

Section: Discussionmentioning

confidence: 99%

An update of oncologic and obstetric outcomes after abdominal trachelectomy using the FIGO 2018 staging system for cervical cancer: a single-institution retrospective analysis

et al. 2023

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Objective To apply the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system to all patients who underwent trachelectomy in our previous study and to update the oncologic and obstetric results. Methods We retrospectively reviewed the medical records of patients in whom abdominal trachelectomy was attempted between June 2005 and September 2021. The FIGO 2018 staging system for cervical cancer was applied to all patients. Results Abdominal trachelectomy was attempted for 265 patients. Trachelectomy was converted to hysterectomy in 35 patients, and trachelectomy was completed successfully in 230 (conversion rate: 13%). Applying the FIGO 2018 staging system, 40% of the patients who underwent radical trachelectomy had stage IA tumors. Among 71 patients who had tumors measuring ≥2 cm, 8 patients were classified as stage IA1 and 14 as stage IA2. Overall recurrence and mortality rates were 2.2% and 1.3%, respectively. One hundred twelve patients attempted to conceive after trachelectomy; 69 pregnancies were achieved in 46 patients (pregnancy rate: 41%). Twenty-three pregnancies ended in first-trimester miscarriage, and 41 infants were delivered between gestational weeks 23 and 37; 16 were deliveries at term (39%) and 25 were premature deliveries (61%). Conclusion This study suggested that patients judged to be ineligible for trachelectomy and patients receiving overtreatment will continue to appear using the current standard eligibility criteria. With the revisions to the FIGO 2018 staging system, the preoperative eligibility criteria for trachelectomy, which were based on the FIGO 2009 staging system and tumor size, should be changed.

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“…This implies that clinically suspect lesions are always at least a stage IB. A study by Takahashi et al [ 16 ] reclassified 25 FIGO 2009 stage IB tumors with a size of <2 cm. Of these 25 patients, 9 (36.0%) were reclassified as stage IA.…”

Section: Discussionmentioning

confidence: 99%

The risk of lymph node metastasis in the new FIGO 2018 stage IA cervical cancer with >7 mm diameter

et al. 2023

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Objective In the 2018 FIGO staging system, cervical cancers with ≤5 mm depth of invasion (DOI) and a diameter of >7 mm, first classified as stage IB, are classified as stage IA. In this group, it is unclear what the risk of lymph node metastasis (LNM) is. This retrospective cohort study aims to determine the incidence of LNM and to study the association between disease-related characteristics and LNM. Methods Women diagnosed with FIGO 2009 IB cervical cancer, with ≤5 mm DOI and a diameter >7 mm, treated with a radical hysterectomy and pelvic lymphadenectomy between 1985 and 2020 were selected from the databases of the Amsterdam University Medical Center and the University Medical Center Groningen. The specimens of patients with LNM were revised by expert pathologists. The incidence of LNM was calculated. The associations between LNM and DOI, diameter, histological type, clinical visibility and lymphovascular space invasion (LVSI) were evaluated by calculating odds ratios using logistic regression. Results Of the 389 patients included, 10 had pathologically confirmed LNM (2.6%, 95% confidence interval=1.3%–4.5%). In case of LVSI, univariate analysis showed an increased risk of LNM (p=0.003 and p=0.012, respectively). No difference in LNM was found between lesions diagnosed by microscopy and clinically visible lesions. No LNM were found in patients without LVSI and a DOI of ≤3 mm. Conclusion For patients with stage IA cervical cancer with a diameter >7 mm, we recommend considering a pelvic lymph node assessment in case of DOI >3 mm and/or presence of LVSI.

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Validation of the FIGO 2018 staging system of cervical cancer: Retrospective analysis of FIGO 2009 stage IB1 cervical cancer with tumor under 2 cm

Cited by 5 publications

References 19 publications

Prognostic value of the 2018 FIGO staging system for cervical cancer

Prognostic value of the 2018 FIGO staging system for cervical cancer

An update of oncologic and obstetric outcomes after abdominal trachelectomy using the FIGO 2018 staging system for cervical cancer: a single-institution retrospective analysis

The risk of lymph node metastasis in the new FIGO 2018 stage IA cervical cancer with >7 mm diameter

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