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Revised FIGO staging for carcinoma of the cervix uteri

2019; Elsevier BV; Volume: 145; Issue: 1 Linguagem: Inglês

10.1002/ijgo.12749

1879-3479

Neerja Bhatla, Jonathan S. Berek, Mauricio Cuello Fredes, Lynette Denny, Seija Grénman, Kanishka Karunaratne, Sean Kehoe, Ikuo Konishi, Alexander Olawaiye, Jaime Prat, Rengaswamy Sankaranarayanan,

Cervical Cancer and HPV Research

Abstract Objective To revise FIGO staging of carcinoma of the cervix uteri, allowing incorporation of imaging and/or pathological findings, and clinical assessment of tumor size and disease extent. Methods Review of literature and consensus view of the FIGO Gynecologic Oncology Committee and related societies and organizations. Results In stage I, revision of the definition of microinvasion and lesion size as follows. Stage IA : lateral extension measurement is removed; stage IB has three subgroups—stage IB 1: invasive carcinomas ≥5 mm and <2 cm in greatest diameter; stage IB 2: tumors 2–4 cm; stage IB 3: tumors ≥4 cm. Imaging or pathology findings may be used to assess retroperitoneal lymph nodes; if metastatic, the case is assigned stage IIIC ; if only pelvic lymph nodes, the case is assigned stage IIIC 1; if para‐aortic nodes are involved, the case is assigned stage IIIC 2. Notations ‘r’ and ‘p’ will indicate the method used to derive the stage—i.e., imaging or pathology, respectively—and should be recorded. Routine investigations and other methods (e.g., examination under anesthesia, cystoscopy, proctoscopy, etc.) are not mandatory and are to be recommended based on clinical findings and standard of care. Conclusion The revised cervical cancer staging is applicable to all resource levels. Data collection and publication will inform future revisions.