Meinhold-Heerlein I, Fotopoulou C, Harter P, Kurzeder C, Mustea A, Wimberger P, Hauptmann S, Sehouli J
Gynäkologie und Geburtsmedizin, Uniklinik RWTH Aachen, Aachen.
Gynäkologie, Universitätsmedizin Charité, Berlin.
Geburtshilfe Frauenheilkd. 2015 Oct;75(10):1021-1027. doi: 10.1055/s-0035-1558079.
More than 25 years after the last revision, in 2012 the FIGO Oncology Committee began revising the FIGO classification for staging ovarian, Fallopian tube and primary peritoneal cancers. The new classification has become effective with its publication at the beginning of 2014. Following recent findings on the pathogenesis of ovarian, Fallopian tube and primary peritoneal cancer and reflecting standard clinical practice, the three entities have now been classified uniformly. The histological subtype is included (high-grade serous - HGSC; low-grade serous - LGSC; mucinous - MC; clear cell - CCC; endometrioid - EC). Stages III and IV have been fundamentally changed: stage IIIA now refers to a localized tumor limited to the pelvis with (only) retroperitoneal lymph node metastasis (formerly classified as IIIC). Stage IV has been divided into IVA and IVB, with IVA defined as malignant pleural effusion and IVB as parenchymatous or extra-abdominal metastasis including inguinal and mediastinal lymph node metastasis as well as umbilical metastasis. A new WHO classification was published almost concurrently. The classification of serous tumors addresses the issue of the tubal carcinogenesis of serous ovarian cancer, even if no tubal precursor lesions are found for up to 30 % of serous high-grade cancers. The number of subgroups was reduced and subgroups now include only high-grade serous, low-grade serous, mucinous, seromucinous, endometrioid, clear cell and Brenner tumors. The category "transitional cell carcinomas" has been dropped and the classification "seromucinous tumors" has been newly added. More attention has been focused on the role of borderline tumors as a stage in the progression from benign to invasive lesions.
在上次修订25年多后,2012年国际妇产科联盟(FIGO)肿瘤委员会开始修订FIGO卵巢癌、输卵管癌和原发性腹膜癌的分期分类。新分类于2014年初发布并生效。基于卵巢癌、输卵管癌和原发性腹膜癌发病机制的最新研究结果,并反映标准临床实践,这三种实体现在已进行统一分类。组织学亚型也被纳入(高级别浆液性癌-HGSC;低级别浆液性癌-LGSC;黏液性癌-MC;透明细胞癌-CCC;子宫内膜样癌-EC)。III期和IV期有了根本性改变:IIIA期现在指局限于盆腔的局部肿瘤伴有(仅)腹膜后淋巴结转移(以前分类为IIIC期)。IV期已分为IVA期和IVB期,IVA期定义为恶性胸腔积液,IVB期为实质或腹外转移,包括腹股沟和纵隔淋巴结转移以及脐转移。几乎同时发布了新的世界卫生组织(WHO)分类。浆液性肿瘤的分类解决了浆液性卵巢癌的输卵管起源问题,即使高达30%的高级别浆液性癌未发现输卵管前驱病变。亚组数量减少,现在亚组仅包括高级别浆液性、低级别浆液性、黏液性、浆液黏液性、子宫内膜样、透明细胞和勃勒纳肿瘤。“移行细胞癌”类别已被删除,新增了“浆液黏液性肿瘤”分类。更多关注集中在交界性肿瘤作为从良性病变进展到侵袭性病变阶段的作用上。