[The 2019 FIGO classification for cervical carcinoma-what's new?]

Area of Science:

• Gynecologic Oncology
• Cancer Staging
• Pathology

Background:

• Cervical carcinoma staging requires precise classification for therapeutic and prognostic accuracy.
• Existing FIGO (International Federation of Gynecology and Obstetrics) staging criteria needed revision based on recent studies.
• Accurate staging is crucial for guiding treatment decisions and predicting patient outcomes in cervical cancer.

Purpose of the Study:

• To revise the FIGO classification system for cervical carcinoma.
• To update staging criteria for microinvasive and macroinvasive cervical cancers.
• To clarify the definition of regional lymph nodes and their involvement in staging.

Main Methods:

• Re-evaluation of diagnostic criteria for microinvasive cervical carcinoma.
• Introduction of new substages for macroinvasive cervical carcinoma based on tumor size.
• Redefinition of pelvic and para-aortic lymph nodes as regional nodes.
• Categorization of lymph node metastasis based on location and extent.

Main Results:

• Microinvasive carcinoma staging now relies exclusively on the depth of cervical stromal invasion.
• Lymphovascular invasion does not impact the stage if beyond the deepest stromal infiltration.
• New FIGO substages (IB1/T1b1, IBII/T1b2, IBII/T1b3) are defined for macroinvasive disease based on tumor dimensions.
• Pelvic lymph node metastasis is FIGO IIIC1/pN1a; para-aortic involvement is FIGO IIIC2/pN1b.
• Uterine corpus and adnexal involvement are excluded from staging.

Conclusions:

• The revised FIGO classification provides a more refined system for cervical carcinoma staging.
• The updated criteria enhance accuracy in differentiating tumor extent and lymph node involvement.
• These revisions will improve therapeutic planning and prognostic assessment for cervical cancer patients.