Rationality verification and evaluate of the 2018 International Federation of Gynecology and Obstetrics staging system for stage ⅠB cervical cancer

doi:10.3969/j.issn.1006-7795.2021.06.020

Abstract

Abstract: Objective The paper aimed to verify and evaluate the stage ⅠB of the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) cervical cancer staging schema from the aspects of clinical characteristics and prognosis, etc. Methods This is a retrospective observational study examining 427 patients from January 1, 2010 to December 31, 2014 with cervical cancer of stage ⅠB1-ⅠB3 classified using the 2018 FIGO staging schema. The clinical characteristic including age, tumor characteristics (Including pathological type, histological grade, deep stromal invasion and infiltration of lymphatic vascular space), treatment (postoperative adjuvant radiotherapy and chemotherapy) and 5-year survival rate were estimated for each group by statistical methods such as group comparison and multi factor analysis. Results Stage ⅠB1 tumors were more likely to be squamous cell and well-moderate grade, whereas the adenocarcinoma, adenosquamous cell and poorly grade were more common in stage ⅠB2-ⅠB3 neoplasms (both P<0.001). The rates of deep stromal invasion and lymph-vascular space invasion (LVSI) in stage ⅠB2 and ⅠB3 tumors were significantly higher than stage ⅠB1 (P<0.001, P<0.05). The probability of postoperative radiotherapy and chemotherapy in stage ⅠB2 and ⅠB3 cohorts were significantly higher than that with stage ⅠB1 (P<0.001).The 5-year overall survival rate in stage ⅠB1, ⅠB2 and ⅠB3 diseases significantly different and decreased in turn, which were 97.9%, 93.4% and 81.5% respectively.The survival curve showed that the curves of each group were well separated, and the difference was statistically significant (P<0.001). Conclusion The FIGO 2018 staging schema revised the new system to ⅠB1(≤2 cm),ⅠB2(＞2 cm~≤4 cm)and ⅠB3(＞4 cm), with invasive carcinoma 2 cm in greatest dimension is regarded as a cut off value,which provides better stratification of the disease and prognostic evaluation for patients of stage ⅠB, and has a good clinical guiding significance.

Key words: cervical cancer, International Federation of Gynecology and Obstetrics (FIGO), staging system, prognosis

CLC Number:

R711

Liu Yang, Wu Yumei, He Yue, Fan Bei, Wang Yan, Zhao Hui, Wang Ming. Rationality verification and evaluate of the 2018 International Federation of Gynecology and Obstetrics staging system for stage ⅠB cervical cancer[J]. Journal of Capital Medical University, 2021, 42(6): 1026-1032.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2021.06.020

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2021/V42/I6/1026

References

[1] Siegel R L, Miller K D, Jemal A. Cancer statistics, 2020[J]. CA Cancer J Clin, 2020, 70(1): 7-30.
[2] De Martel C, Georges D, Bray F, et al. Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis[J]. Lancet Glob Health, 2020, 8(2): e180-e190.
[3] Dabi Y, Simon V, Carcopino X, et al. Therapeutic value of surgical paraaortic staging in locally advanced cervical cancer: a multicenter cohort analysis from the FRANCOGYN study group[J]. J Transl Med, 2018, 16(1): 326.
[4] Bhatla N, Berek J S, Cuello Fredes M, et al. Revised FIGO staging for carcinoma of the cervix uteri[J]. Int J Gynaecol Obstet, 2019, 145(1): 129-135.
[5] Bhatla N, Berek J S, Cuello Fredes M, et al. Revised FIGO staging for carcinoma of the cervix uteri[J]. Int J Gynaecol Obstet, 2019, 147(2): 279-280.
[6] National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology -cervical cancer: version 1[EB/OL]. (2020-10-02)[2020-01-14].https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1426.
[7] Melamed A, Margul D J, Chen L, et al. Survival after minimally invasive radical hysterectomy for early-stage cervical cancer[J]. N Engl J Med, 2018, 379(20): 1905-1914.
[8] 詹银珠,刘峰,刘育飞,等.临床早期宫颈癌宫旁转移相关因素分析[J].中华肿瘤防治杂志,2018,25(14):1019-1022.
[9] Kubota S, Kobayashi E, Kakuda M, et al. Retrospective analysis for predictors of parametrial involvement in IB cervical cancer[J]. J Obstet Gynaecol Res, 2019, 45(3): 679-685.
[10] Matsuo K, Machida H, Mandelbaum R S, et al. Validation of the 2018 FIGO cervical cancer staging system[J]. Gynecol Oncol, 2019, 152(1): 87-93.
[11] Wright J D, Matsuo K, Huang Y M, et al. Prognostic performance of the 2018 international federation of gynecology and obstetrics cervical cancer staging guidelines[J]. Obstet Gynecol, 2019, 134(1): 49-57.
[12] Diaz J P, Sonoda Y, Leitao M M, et al. Oncologic outcome of fertility-sparing radical trachelectomy versus radical hysterectomy for stage IB1 cervical carcinoma[J]. Gynecol Oncol, 2008, 111(2): 255-260.
[13] Lanowska M, Mangler M, Speiser D, et al. Radical vaginal trachelectomy after laparoscopic staging and neoadjuvant chemotherapy in women with early-stage cervical cancer over 2 cm: oncologic, fertility, and neonatal outcome in a series of 20 patients[J]. Int J Gynecol Cancer, 2014, 24(3): 586-593.
[14] Parra-Herran C, Taljaard M, Djordjevic B, et al. Pattern-based classification of invasive endocervical adenocarcinoma, depth of invasion measurement and distinction from adenocarcinoma in situ: interobserver variation among gynecologic pathologists[J]. Mod Pathol, 2016, 29(8): 879-892.
[15] Roma A A, Mistretta T A, Diaz De Vivar A, et al. New pattern-based personalized risk stratification system for endocervical adenocarcinoma with important clinical implications and surgical outcome[J]. Gynecol Oncol, 2016, 141(1): 36-42.
[16] Bats A S, Mathevet P, Buenerd A, et al. The sentinel node technique detects unexpected drainage pathways and allows nodal ultrastaging in early cervical cancer: insights from the multicenter prospective SENTICOL study[J]. Ann Surg Oncol, 2013, 20(2): 413-422.
[17] Eiriksson L R, Covens A. Sentinel lymph node mapping in cervical cancer: the future?[J]. BJOG, 2012, 119(2): 129-133.