Department of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, 683-8505, Japan.
Department of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishimachi, Yonago, 683-8505, Japan.
Taiwan J Obstet Gynecol. 2021 Nov;60(6):1054-1058. doi: 10.1016/j.tjog.2021.09.016.
We re-classified patients with stage IB-II disease (based on the 2008 system) and compared the outcomes with those obtained after using the 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system.
We reviewed the data of 154 patients with cervical cancer who underwent radical hysterectomy at our hospital during 2006-2016. Pathological, histological, and radiographic data were used to re-classify the cases based on the 2018 FIGO system. We compared these outcomes to those obtained after using the 2008 FIGO assignments. Overall survival (OS) was calculated from primary therapy initiation until death or the last follow-up examination.
The histological types were squamous cell carcinoma (108 cases) and others (46 cases). The 2008 FIGO system assignments were stage IB1, IB2, IIA1, IIA2, and IIB (87, 27, seven, five, and 28 patients, respectively). The new 2018 FIGO system assignments were stage IB1, IB2, IB3, IIA1, IIA2, IIB, and IIIC1 (52, 26, 16, six, three, 21, and 30 patients, respectively). Re-classification to stage IIIC1 disease was observed for previously assigned stage IB1, IB2, IIA1, IIA2, and IIB cases (10, seven, two, two, and nine cases, respectively). The median OS durations based on the 2018 FIGO system were 71.7, 61.1, and 62.3 months for patients with stage IB1, IB2, and IB3 (p = 0.04) disease, respectively. The new stage IB3/IIA2/IIB cases had longer OS than the old stage IB2/IIA2/IIB cases. A positive computed tomography (CT) finding of nodal involvement was observed in 37% of cases with pathological confirmation of pelvic lymph node (LN) involvement. Using CT to identify pelvic LN metastasis had a sensitivity of 37% and specificity of 93%.
The 2018 FIGO staging system for cervical cancer after radical hysterectomy showed a better ability to differentiate survival outcomes. However, the image evaluation method should be reconsidered.
我们重新分类了 2008 系统中 IB-II 期（基于 2018 年国际妇产科联合会 FIGO 分期系统）的患者，并比较了使用 2018 年 FIGO 分期系统和 2008 年 FIGO 分期系统的结果。
我们回顾了 2006 年至 2016 年期间在我院接受根治性子宫切除术的 154 例宫颈癌患者的资料。使用病理学、组织学和影像学数据，根据 2018 年 FIGO 系统重新分类病例。我们将这些结果与使用 2008 年 FIGO 分配的结果进行比较。总生存（OS）从开始原发性治疗到死亡或最后一次随访检查。
组织学类型为鳞状细胞癌（108 例）和其他类型（46 例）。2008 年 FIGO 系统分配为 IB1、IB2、IIA1、IIA2 和 IIB（87、27、7、5 和 28 例患者）。新的 2018 年 FIGO 系统分配为 IB1、IB2、IB3、IA1、IA2、IIB 和 IIIC1（52、26、16、6、3、21 和 30 例患者）。重新分类为 IIIC1 期疾病见于先前分配为 IB1、IB2、IA1、IA2 和 IIB 期的病例（分别为 10、7、2、2 和 9 例）。根据 2018 年 FIGO 系统，IB1、IB2 和 IB3 期患者的中位 OS 分别为 71.7、61.1 和 62.3 个月（p=0.04）。新的 IB3/IA2/IIB 病例的 OS 长于旧的 IB2/IA2/IIB 病例。在有盆腔淋巴结（LN）病理证实的情况下，37%的病例 CT 检查发现淋巴结受累。使用 CT 识别盆腔 LN 转移的敏感性为 37%，特异性为 93%。
根治性子宫切除术后宫颈癌的 2018 年 FIGO 分期系统显示出更好的生存结果区分能力。然而，应重新考虑图像评估方法。
