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Small FIGO stage IB cervical cancer

F Girardi¹, E Burghardt, H Pickel

¹Department of Obstetrics and Gynecology, University of Graz, Austria.

Gynecologic Oncology

|December 1, 1994

Summary

The International Federation of Gynecology and Obstetrics (FIGO) stage IA cervical cancer definition may need expansion. Lesions exceeding current FIGO stage IA criteria showed no recurrences, suggesting current staging may be too restrictive for microinvasive cervical cancer.

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Area of Science:

Gynecologic Oncology
Pathology
Cancer Staging

Background:

Current FIGO staging for stage IA cervical cancer defines invasion up to 5 mm depth and 7 mm width, excluding vascular invasion from staging.
The Society of Gynecologic Oncology (SGO) has a more restrictive depth criterion but does not consider lesion width.

Purpose of the Study:

To evaluate the clinical outcomes of cervical cancer patients whose lesions exceeded the FIGO stage IA definition.
To assess the correlation between lesion characteristics (depth, width, vascular invasion) and treatment outcomes.

Main Methods:

Retrospective review of 69 patients treated for cervical cancer lesions exceeding FIGO stage IA criteria between 1958 and 1991.
Analysis of treatment modalities including conization, hysterectomy, and radiotherapy.
Correlation analysis of lesion depth, width, vascular invasion, and lymph node status.

Main Results:

No recurrences were observed in any patient during a 2-35 year follow-up period.
Vascular invasion frequency correlated with lesion width, not depth.
Two patients with lymphadenectomy had one positive lymph node each, with varying lesion characteristics.

Conclusions:

Cervical cancer cases exceeding current FIGO stage IA criteria, including some small stage IB disease, may not require aggressive treatment and can have favorable outcomes.
The current FIGO classification for stage IA2 cervical cancer should be expanded, not restricted, to better encompass these cases.
A single staging system may not adequately serve as both a diagnostic and treatment guideline for microinvasive cervical cancer.

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