The revised FIGO staging system for uterine malignancies: implications for MR imaging

Area of Science:

• Gynecologic Oncology
• Diagnostic Imaging
• Clinical Staging

Background:

• Gynecologic malignancies, including uterine corpus and cervical cancers, are globally prevalent.
• The International Federation of Gynecology and Obstetrics (FIGO) staging system, established in 1958, guides treatment based on tumor spread.
• Recent FIGO updates reflect evolving tumor biology and distinct treatment strategies for endometrial and cervical cancers.

Purpose of the Study:

• To evaluate the role of Magnetic Resonance (MR) imaging in staging uterine corpus and cervical cancers.
• To highlight how MR imaging findings, combined with clinical and histologic data, improve risk stratification and treatment planning.

Main Methods:

• Staging for endometrial cancer relies on surgical and histologic analysis, with MR imaging used for pre-operative assessment of tumor extent.
• Cervical carcinoma is primarily staged clinically due to inoperability at presentation; MR imaging serves as a recommended adjunct.
• Multidisciplinary discussion integrating MR imaging, clinical, and histologic findings is crucial for accurate staging.

Main Results:

• MR imaging accurately depicts endometrial cancer extent, aiding risk stratification alongside tumor grade and subtype.
• While not formally in the revised FIGO staging for cervical cancer, MR imaging is highly sensitive and specific for prognostic factors.
• The integration of MR imaging findings improves the accuracy of staging and risk stratification for both uterine cancers.

Conclusions:

• MR imaging is a valuable tool for staging endometrial cancer, guiding therapeutic decisions.
• For cervical cancer, MR imaging enhances clinical staging, particularly in resource-limited settings.
• A multidisciplinary approach incorporating MR imaging, clinical, and histologic data ensures precise staging and personalized treatment for uterine malignancies.