Revised International Federation of Gynecology and Obstetrics (FIGO) staging systems in gynecologic malignancies

Maria Lee; Young Tae Kim

doi:10.5468/kjog.2010.53.8.669

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Lee and Kim: Revised International Federation of Gynecology and Obstetrics (FIGO) staging systems in gynecologic malignancies

Recent Clinical Review

Korean Journal of Obstetrics and Gynecology

Korean Journal of Obstetrics and Gynecology 2010; 53(8): 669-680.

Published online: 19 August 2010

DOI: https://doi.org/10.5468/kjog.2010.53.8.669

Revised International Federation of Gynecology and Obstetrics (FIGO) staging systems in gynecologic malignancies

Maria Lee, M.D., Young Tae Kim, M.D., Ph.D.

Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author (ytkchoi@yuhs.ac)

Received 3 May 2010 Accepted 22 June 2010

Abstract

The International Federation of Gynecology and Obstetrics (FIGO) has reported annually for the development and changes of gynecologic cancer classification and staging since 1958. FIGO staging systems in gynecologic malignancies has been reflected on prognostic factors in predicting patients' outcomes and organized patients into several groups. The aim of the FIGO staging system is to afford a classification of gynecologic cancer and to share treatment methods with others. The FIGO staging systems have been updated several times every 3 years according to the latest data, which is responsive and adaptive to scientific development including imaging and treatment modalities. In 2008, the FIGO staging system for carcinoma of the cervix, endometrium, vulva, and uterine sarcomas was revised. After applying the revised staging system in clinical setting, it is need to consider and review problems. As a result, we must make up for the weak points in staging systems continuously.

Keywords: FIGO, Staging systems, Gynecologic malignancies

Figures and Tables

Table 1

Staging procedures

^*Allowed by International Federation of Gynecology and Obstetrics (FIGO).

^†Information that is not allowed by FIGO to change the clinical stage.

Table 2

The International Federation of Gynecology and Obstetrics (FIGO) clinical staging for uterine cervix (2008)

^*All macroscopically visible lesions-even with superficial invasion-are allotted to stage IB carcinomas. Invasion is limited to a measured stromal invasion with a maximal depth of 5.00 mm and a horizontal extension of not >7.00 mm. Depth of invasion should not be >5.00 mm taken from the base of the epithelium of the original tissue-superficial or glandular. The depth of invasion should always be reported in mm, even in those cases with "early (minimal) stromal invasion" (~1 mm). The involvement of vascular/lymphatic spaces should not change the stage allotment.

^†On rectal examination, there is no cancer-free space between the tumor and the pelvic wall. All cases with hydronephrosis or non-functioning kidney are included, unless they are known to be due to another cause.

Table 3

Modified World Health Organization (WHO) histological classification of malignant tumors of the uterine cervix by the Gynecological Pathology Study Group of the Korean Society of Pathologists

Table 4

Histopathologic grade of malignant tumors of the uterine cervix

Table 5

The International Federation of Gynecology and Obstetrics (FIGO) staging for endometrial cancer (2008)

^*Either G1, G2, or G3.

^†Endocervical glandular involvement only should be considered as Stage I and no longer as Stage II.

^‡Positive cytology has to be reported separately without changing the stage.

Table 6

Histopathologic grade of endometrial carcinoma

Table 7

Modified World Health Organization (WHO) histological classification of malignant tumors of the uterine corpus by the Gynecological Pathology Study Group of the Korean Society of Pathologists

Table 8

The International Federation of Gynecology and Obstetrics (FIGO) staging for leiomyosarcomas and Endometrial stromal sarcomas (ESS) and Adenosarcomas^*

^*Simultaneous tumors of the uterine corpus and ovary/pelvis in association with ovarian/pelvic endometriosis should be classified as independent primary tumors.

Table 9

The International Federation of Gynecology and Obstetrics (FIGO) staging for ovarian cancer (2008)

Table 10

Modified World Health Organization (WHO) classification for ovarian cancer by the Gynecological Pathology Study Group of the Korean Society of Pathologists

Table 11

Histopathologic grade of ovarian cancer

Table 12

The International Federation of Gynecology and Obstetrics (FIGO) staging for vaginal cancer

Table 13

The International Federation of Gynecology and Obstetrics (FIGO) staging for vulva cancer (2008)

^*The depth of invasion is defined as the measurement of the tumor from the epithelialstromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion.

Table 14

Microstaging of vulvar melanoma

Table 15

The International Federation of Gynecology and Obstetrics (FIGO) staging for gestational trophoblastic neoplasia

Table 16

The International Federation of Gynecology and Obstetrics (FIGO) 2000 classification for gestational trophoblastic neoplasia

References

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9. Homesley HD, Bundy BN, Sedlis A, Yordan E, Berek JS, Jahshan A, et al. Assessment of current International Federation of Gynecology and Obstetrics staging of vulvar carcinoma relative to prognostic factors for survival (a Gynecologic Oncology Group study). Am J Obstet Gynecol. 1991. 164:997–1003. discussion-4.

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12. Kohorn EI. The new FIGO 2000 staging and risk factor scoring system for gestational trophoblastic disease: description and critical assessment. Int J Gynecol Cancer. 2001. 11:73–77.

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