Staging early cervical cancer in China: data from a multicenter collaborative.

Area of Science:

• Gynecologic Oncology
• Cancer Staging
• Clinical Accuracy

Background:

• The International Federation of Gynecology and Obstetrics (FIGO) revised cervical cancer staging in 2018.
• Assessing pre-revision staging accuracy in China is crucial for understanding historical data and guiding future improvements.

Purpose of the Study:

• To evaluate the accuracy of clinical staging for early-stage cervical cancer in China using the 2009 FIGO staging system.
• Identify factors contributing to staging inaccuracies in cervical cancer.

Main Methods:

• Multicenter retrospective study of 12,681 patients with early-stage cervical cancer (IA-IIA2) treated surgically between 2010-2015.
• Clinical staging (2009 FIGO) compared against pathological findings.
• Analysis of reasons for discrepancies in cervical cancer staging.

Main Results:

• Overall clinical staging accuracy was 69.6%, with 21.0% overstaged and 9.4% understaged.
• Accuracy varied significantly by stage: IA (90.0%), IB1 (87.5%), IB2 (57.4%), IIA1 (20.3%), IIA2 (25.5%).
• Primary causes for inaccuracy included vaginal involvement (62.3%) and maximal tumor diameter (24.6%) in cervical cancer.

Conclusions:

• Clinical staging of early cervical cancer in China was suboptimal prior to the 2018 FIGO revision.
• Staging inaccuracies were particularly pronounced for stages IIA1 and IIA2.
• Vaginal involvement and tumor diameter are critical factors influencing cervical cancer staging accuracy.