Revised FIGO staging for carcinoma of the cervix uteri
- Study type
- Clinical guideline
- Study name
- FIGO 2018
- Design
- Staging revision based on a literature review and the consensus opinion of the Gynaecologic Oncology Committee of the International Federation of Gynaecology and Obstetrics (FIGO) and related societies and organisations
- Sample size
- Not applicable (consensus/guidance document)
- Source
- Intl J Gynecology & Obste · 2019
In plain words
Staging is a way of showing how big a cervical cancer is and how far it has spread. In this revised version, tumour size is classified more precisely, and results of scans or pathology can also be used to decide the stage, especially for the lymph nodes. This system can be used by treatment centres with different levels of resources. Treatment decisions should be made together with your treating doctor.
Key points
Key guideline recommendations
- FIGO committee consensus
In stage IA, measurement of lateral extension is removed. Stage IB is divided into three subgroups: IB1 (invasive carcinoma with depth ≥5 mm and greatest dimension <2 cm), IB2 (tumour 2 to 4 cm) and IB3 (tumour ≥4 cm).
- FIGO committee consensus
Imaging or pathology findings can be used to assess the retroperitoneal lymph nodes. If the nodes are metastatic, the disease is assigned to stage IIIC (IIIC1 for involvement of pelvic nodes only and IIIC2 for para-aortic nodes).
- FIGO committee consensus
The notations "r" and "p" should be recorded to indicate the method used to assign the stage (imaging or pathology, respectively).
- FIGO committee consensus
Routine investigations and other methods (such as examination under anaesthesia, cystoscopy and proctoscopy) are not mandatory and should be recommended based on clinical findings and the standard of care.
Study population
This document addresses the staging of patients with carcinoma of the cervix. The abstract does not report patient inclusion criteria.
Endpoints
The aim is to revise the FIGO staging of cervical carcinoma so that imaging and/or pathology findings, as well as clinical assessment of tumour size and extent of disease, can be used.
Safety and side effects
Not applicable; this document is a staging system and reports no safety outcomes.
Clinical significance and place in guidelines
This revision allows imaging and pathology to be used in staging, divides stage I into more precise subgroups and defines lymph node involvement as stage IIIC. According to the authors, this staging is feasible in all resource settings. The abstract does not comment on adoption in other clinical guidelines, and its status in current guidelines should be checked separately.
Limitations
The abstract does not report levels of evidence or grades of recommendation; it is based on a literature review and committee consensus. An erratum to this article has been published in the same journal (Int J Gynaecol Obstet. 2019;147(2):279-280); the full text and erratum should be consulted for the final definitions. The authors note that collecting and publishing data will guide future revisions.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.