Pdf endometrial cancer is the most commonly diagnosed gynecologic malignancy in the united states. Significant changes have been made to the 2009 figo staging system for endometrial cancer, which has important implications for radiologists. Revised figo staging for endometrial cancer south afr j gynaecol oncol 2010 vol 2 no 2 revised figo staging for endometrial cancer cancer staging is one of the fundamental activities in oncology and is of pivotal importance to the modern management of cancer patients. For uterine cancer, the staging system developed by the international federation of obstetrics and gynecology figo is used. Cancer of the endometrium lining of the uterus is the most common gynecologic malignancy in developed countries and the second most common in developing countries cervical cancer is more common. Since publicationof the last figo cervical cancer staging in 2009, considerable progress has been made in the use of imaging modalities to evaluate women with cervical cancer. The revised 2009 figo staging system for endometrial. Endometrial cancer staging is depend on the pathologic criteria the recent change in the federation of gynecology and. The revised figo staging system for cervical carcinoma was implemented on june 1, 2009.
We sought to describe the overall survival os of women with stage i endometrial cancer and examine how the estimated stagespecific os is. Figo s staging classification for cancer of the ovary j gynecol oncol vol. The cancer staging system looks at how far the cancer has spread. In europe, 1 to 2 in every 100 women will develop endometrial cancer at some point in their life. Cervix, uterine, vulva international gynecologic cancer society. Revised figo staging for endometrial cancer south afr j gynaecol oncol 2010 vol 2 no 2 lymphadenectomy14 is not mandatory to stage all patients with endometrial cancer, it is recommended in operable highrisk clinical stage i patients and in those.
In 1988, the international federation of obstetricians and gynecologists figo made significant changes to the staging scheme for cancers of the uterine corpus, replacing the clinically based 1970 classification with a surgicopathologic system tables 1, 2. Endometrial cancer extending into the endocervical canal. Ppt endometrial cancer powerpoint presentation free to. A total of 355 patients with endometrial cancer, who underwent complete surgical staging, were enrolled. Conclusion in this study, the 1988 figo classification for endometrial cancer is at least as accurate as the 2009 figo classification for predicting endometrial cancer mortality. Comprehensive surgical staging for endometrial cancer ncbi. We present adjuvant therapy options for early endometrial cancer. In this most recent classification, imaging modalities and pathologic information have been added as tools to determine the final stage of the disease. The first rules for classification and staging of female genital cancers adopted by the. Radiological evaluation, based on transvaginal ultrasound, mr and ct, can.
Cervix uteri cancer staging 7th edition primary tumor t tnm figo categories stages tx primary tumor cannot be assessed cannot be assessedt0 no evidence of primary tumor tis carcinoma in situ preinvasive carcinoma t1 i cervical carcinoma confined to. This staging now applies only to endometrial carcinomas and there is now a separate staging for uterine sarcomas. Firstlevel treatment, if no contraindicated, is based on surgery. The most common staging system for uterine cancer is the figo system. They both stage classify this cancer based on 3 factors. Mr staging accuracy for endometrial cancer based on the. In each patient, an endometrial cancer was staged using mr findings based on the old figo staging system and then repeated according to the new figo staging system for comparison. Oct 11, 2018 the figo committee for gynecologic oncology is pleased to present the third edition of the figo cancer report. In 1998, international federation of gynaecologists and obstetricians figo required a change from clinical to surgical staging in endometrial cancer, introducing pelvic and paraaortic lymphadenectomy. Endometrial cancer for example can spread locally to other parts of the uterus. Imaging of endometrial and cervical cancer springerlink. Endometrial carcinoma staging allows appropriate treatment options to be considered and enables greater prognostic accuracy for endometrial carcinoma. The stage provides a common way of describing the cancer, enabling doctors to work together to plan the best treatments.
The 2 systems used for staging endometrial cancer, the figo international federation of gynecology and obstetrics system and the american joint committee on cancer tnm staging system are basically the same. Revised figo staging for carcinoma of the cervix uteri. The figo surgical staging for endometrial cancer was revised in 2009. Endometrial cancer is a disease in which malignant cancer cells form in the tissues of the endometrium.
Revised figo staging for carcinoma of the vulva, cervix, and endometrium. Consequently, all data and evidence for management of endometrial cancers are available on the basis of. Endometrial cancer can occur at any age, although it is much more common in women who have been through menopause when monthly periods stop. New revised figo 2008 staging system for endometrial.
Endometrial cancer is the most common gynaecological malignancy and its incidence is increasing. Although there are many merits to this new staging for cervical cancer, including more detailed. Any agentfactor that rises the level or time of exposure to estrogen is a risk factor for endometrial carcinoma 8. Between january 2005 and may 2009, 199 women underwent surgery due to endometrial cancer. We discuss treatment for endometrial cancer including chemotherapy, radiation, and hormones. Revision of figo surgical staging in 2009 for endometrial. We need to continue to gain consensus internationally by having cross representation on our table 1 2014 figo ovarian, fallopian tube, and peritoneal cancer staging system and corresponding tnm. It can also spread regionally through the lymph nodes found in the pelvis or slightly further away to the aorta lymph nodes the main artery which runs down the back of the abdomen and pelvis. Prior to 1988, figo staging for endometrial cancer was clinically based. Endometrial cancer remains the most common malignancy of the female gynecologic tract. Grading describes how the cancer cells look under a microscope compared to normal cells and how aggressive they may be. Endometrial and cervical cancer are the most common gynecologic malignancies in the world. Endometrial cancer is usually diagnosed at an early stage and can be treated with surgery. Sgo clinical practice endometrial cancer working group.
This lesion was thought to be confined to the endocervical canal but on histology there was minimal invasion of tumour into the cervical stroma figo ii. The 2 systems used for staging endometrial cancer, the figo international federation of gynecology and. Endometrial cancer is the most common gynaecologic malignancy in developed countries and its incidence is increasing. Figo staging system for endometrial cancer stage ii endometrial cancer in a 64yearold woman. For these types of uterine cancer, there are 4 stages. This occurred in part because of a change during the previous decade in the clinical management of endometrial carcinoma, with. The revised 2009 figo staging system for endometrial cancer included many changes over the 1988 system, particularly for stage i subgroups. Staging for vaginal cancer is based on clinical evaluation according to the figo system.
We sought to describe the overall survival os of women with stage i endometrial cancer and examine how the estimated stagespecific os is altered in the 2009 system. Histopathologic findings were used as a standard of reference. Risk factors contd hx of other estrogen dependent neoplasm breast, ovary. The figo committee for gynecologic oncology is pleased to present the third edition of the figo cancer report. The revised 2009 figo staging system for endometrial cancer.
Endometrial carcinoma staging radiology reference article. Some early cancers may have signs and symptoms that can be noticed, but thats not always the case. Here, an expert outlines the management of earlystage disease, including surgical staging, and explores the role of adjuvant radiation therapy, lymphnode sampling, and laparoscopy. Endometrial cancer treatment pdqhealth professional. The figo staging system recently underwent significant revision, which has important. Mr imaging assessment of endometrial cancer is discussed in terms of imaging protocol. The revised 2009 figo staging for endometrial cancer 2009 figo staging modifications the 4 main modifications to the 1998 figo staging criteria are as follows. After a cancer diagnosis, staging provides important information about the amount of. Pdf cancers of the uterine corpus and cervix are the most common gynecologic malignancies worldwide.
Controversies in surgical staging of endometrial cancer. We compared the surgical stages and survival by figo 1988 staging system with those by figo 2008 staging system. Correct staging is a cornerstone in cancer treatment. In most nonpregnant women, the uterus is about 3 inches long. We have evaluated if the revision improved stratification with respect to prognosis in a large prospective multicenter setting. The endometrium is the lining of the uterus, a hollow, muscular organ in a womans pelvis. Endometrial cancer is the most common cancer of the organs of the female reproductive system. Publication of this supplement was supported by figo funding to the figo committee for gynecologic oncology. Staging is a way to describe the size of the cancer and whether it has spread to other parts of the body. The international federation of gynecology and obstetrics figo ovarian cancer staging system was first published in 1973 and was revised in 1988 and 2014 1, 2. Revised 2018 international federation of gynecology and.
Figo management of gynecolocical cancers iphone link android link figo cancer reports 2012 and 2015 global guidance for cervical cancer prevention and control 2009. Endometrial cancer early detection, diagnosis, and staging. Myometrial invasion in the 1998 figo staging criteria, stage ia referred to disease within the endometrium, but with preservation of the junctional zone and no myometrial. Endometrial cancer early detection, diagnosis, and staging cancer. In the new figo staging system, the following three changes, which affect imaging and interpretation, were made. Comprehensive surgical staging for endometrial cancer. The international federation of gynecology and obstetrics figo staging system was first established in. Tumor involves 1 or both ovaries with cytologically or histologically confirmed spread to the peritoneum outside the pelvis andor metastasis to the retroperitoneal lymph nodes old new iiia microscopic metastasis beyond the pelvis.
Figo endometrial cancer staging is based on surgical pathology, and comprehensive surgery allows for accurate definition of disease extent. The last revision of the international federation of obstetricians and gynecologists figo staging of uterine corpus tumors was in 1988, and it represented the transition from a clinical to a surgicopathologic system. Predictors of postoperative overall and severe complications after surgical treatment for endometrial cancer. Jun 27, 2012 a total of 355 patients with endometrial cancer, who underwent complete surgical staging, were enrolled. The aim of this study was to analyze the stage migration and survival of endometrial cancer by the revised figo 2008 staging system compared with the 1988 staging system. Since 2012, this report has been presented triennially in the current format, which aims to present the state of the art management of gynecological cancers in our endeavor to ensure women worldwide receive an acceptable standard of care. Endometrial cancer survival by clinical stage stage survival i 70. Often the stages 1 to 4 are written as the roman numerals i, ii, iii and iv. In the european union, over 88,000 women are diagnosed with an endometrial cancer each year.
The value of mr imaging in staging endometrial and cervical carcinoma is discussed with emphasis on its effect on determining prognosis and. Cervix uteri cancer staging 7th edition primary tumor t tnm figo categories stages tx primary tumor cannot be assessed cannot be assessedt0 no evidence of primary tumor tis carcinoma in situ preinvasive carcinoma t1 i cervical carcinoma confined to uterus extension to corpus should be disregarded. Vaginal brachytherapy2 or pelvic radiation therapy with or without concurrent chemotherapy followed by adjuvant chemotherapy3 stage iiib. Endometrial cancer is a great concern in industrialized nations, where it is the most common gynecologic cancerwith incidence increasing every year. Endometrioid carcinoma is the most common histologic type of endometrial carcinoma and of uterine malignancy overall. Cancer staging is a fundamental principle and one of the first and most important steps used to predict patient outcome as well as to plan the most appropriate treatment. Recently the revised 2018 international federation of gynecology and obstetrics figo staging system for cervical cancer was published. This system allows the use of chest radiographs, examination under anesthesia with bimanual and rectovaginal examination, cystoscopy andor proctoscopy in patients with urinary or rectal symptoms, and intravenous pyelogram to evaluate for hydronephrosis. Preoperative imaging is needed for evaluation of local extent and detection of distant metastases in order to guide treatment planning.
Ajcc 7th edition 2009 corresponds to updated figo staging 2009 figo 2009 pmid 19345353 revised figo staging for carcinoma of the endometrium. Survival is generally very good for women who have lowgrade disease confined to the uterus. The following is the consensus agreement that resulted from these efforts and represents new criteria for staging of these gynecologic cancer table 1. Endometrial cancer early detection, diagnosis, and staging 1. This article discusses the risk factors, symptoms, and diagnosis of the most common type of endometrial cancer, called endometrioid endometrial cancer. Carcinosarcomas mmmt should be staged as high grade carcinoma. Current management of earlystage endometrial cancer. Current management of earlystage endometrial cancer mdedge. Mr staging accuracy for endometrial cancer based on the new. Tumor involves 1 or both ovaries with cytologically or histologically confirmed spread to the peritoneum outside the pelvis andor metastasis to the retroperitoneal lymph nodes old. The revised figo staging system for uterine malignancies. The figo system is used to stage endometrial carcinoma, uterine carcinosarcoma and uterine sarcoma. In some cases, imaging scans can show if the cancer has spread, but it is often not possible to be sure of the stage until after surgery. Stage1 adjuvant therapy 1 see appendix a 3for figo staging 2 4preferred vaginal brachytherapy2 followed by adjuvant chemotherapy.
Revised figo staging for endometrial cancer 41 guest editorial. Ovarian cancer, the revised figo staging system, and the. The concordance index for the 2009 figo classification was lower than that of the 1988 figo classification 0. Figo grade 1 or 2 endometrioid carcinomas limited to the inner half of endometrium will not bene. Accurate staging of cervical and endometrial cancer is essential to determine the correct treatment approach. Staging can be based on the tnm or figo system mr imaging is the modality of choice for staging with ct having relatively low specificity especially for myometrial invasion 5 figo system. Pdf the revised figo staging system for uterine malignancies. Key changes include simplification of stage i disease and removal of cervical mucosal invasion as a distinct stage. Figos staging classification for cancer of the ovary.
New revised figo 2008 staging system for endometrial cancer. Prognostic value of the 2009 figo staging for endometrial. The advantages of comprehensive surgical staging lie in diagnosis, prognosis, and proper triage of patients for adjuvant therapy. Staging staging can be based on the tnm or figo system. Am e ric an j o int co mmit te e o n can ce r cervix uteri. The figo staging system recently underwent significant revision, which has. First, the use of diagnostic imaging, including ct and mr imaging, to stage cervical tumors is recommended but remains nonmandatory 55. Radiation oncologyendometriumstaging wikibooks, open.
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