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Influence of the New FIGO Classification for Cervical Cancer on Patient Survival: A Retrospective Analysis of 265 Histologically Confirmed Cases with FIGO Stages IA to IIB

Amelie De Gregorio, Peter Widschwendter, Florian Ebner, Thomas Wolfram Paul Friedl, Jens Huober, Wolfgang Janni & Nikolaus De Gregorio

abstract

OBJECTIVE
At the end of the year 2018, a new FIGO classification for cervical cancer was published, mainly revising stage IB and introducing a new stage IIIC, which includes irrespectively of tumor size and local spread all patients with lymph node metastasis.

METHODS
We retrospectively analyzed all cases of cervical cancer stage I to IIB who underwent surgery as primary treatment at our institution from 2000 until 2016 and therefore had a histological confirmation of tumor stage. We reclassified all histologies according to the new FIGO classification and calculated outcome according to the new stages.

RESULTS
Out of 265 patients, 146 (55%) patients were reclassified into a higher FIGO stage. Most changes appeared within stage IB and from any stage to stage IIIC1. Kaplan-Meier curves for new stages showed a significant difference in disease-free survival (DFS) and overall survival (OS) between stages I versus II versus III (log-rank test, both p < 0.001). Overall, patients that were upstaged had a significant worse DFS (p = 0.012) and OS (p = 0.008) than patients whose stage did not change. Similar observations were made within sub-stages, when node-positive IB or IIB tumors were upstaged to IIIC tumors.

CONCLUSION
The new FIGO classification for cervical cancer reflects the strong impact of lymph node metastases on survival and is a clear improvement compared to the old FIGO classification with regard to risk stratification.
   
citation De Gregorio A, Widschwendter P, Ebner F, Friedl T W P, Huober J, Janni W, De Gregorio N. Influence of the New FIGO Classification for Cervical Cancer on Patient Survival: A Retrospective Analysis of 265 Histologically Confirmed Cases with FIGO Stages IA to IIB. Oncology 2019; 98:91-97.
   
type journal paper/review (English)
date of publishing 08-10-2019
journal title Oncology (98/2)
ISSN electronic 1423-0232
pages 91-97
PubMed 31593942
DOI 10.1159/000503149