FIGO Classification 2018: Validation Study in Patients With Locally Advanced Cervix Cancer Treated With...

Area of Science:

• Gynecologic Oncology
• Radiation Oncology
• Medical Imaging

Background:

• The International Federation of Gynecology and Obstetrics (FIGO) introduced a new staging system for cervical cancer in 2018.
• Accurate staging is crucial for treatment planning and outcome prediction in locally advanced cervical cancer.

Purpose of the Study:

• To reclassify patients with locally advanced cervical cancer using the FIGO 2018 staging system.
• To compare survival outcomes between the FIGO 2009 and FIGO 2018 staging systems.
• To evaluate the prognostic value of clinical stage and other factors in cervical cancer.

Main Methods:

• Retrospective analysis of 632 patients with locally advanced cervical cancer (stage IB2-IVA).
• Patients were staged using FIGO 2009 and reclassified using FIGO 2018 criteria.
• Survival outcomes, including disease-free survival (DFS), were analyzed based on staging and prognostic factors like lymph node status and tumor volume.

Main Results:

• The FIGO 2018 staging demonstrated different survival rates compared to FIGO 2009.
• Patients with pelvic adenopathy or positive para-aortic nodes had significantly inferior outcomes.
• Primary tumor volume >30 cm³ and ≥3 para-aortic nodes were associated with worse 3-year DFS.

Conclusions:

• The FIGO 2018 staging modification shows heterogeneous outcomes, particularly in node-positive patients, influenced by tumor and nodal volume.
• A revised TNM staging system is proposed to improve the classification of outcomes in cervical cancer.
• Clinical factors such as lymph node status and tumor volume are critical prognostic indicators.