The revised 2014 figo staging system for epithelial ovarian. Often the stages 1 to 4 are written as the roman numerals i, ii, iii and iv. And within a stage, an earlier letter means a lower stage. Staging classification for cancer of the ovary, fallopian tube. The sensitivity of doppler ultrasound in the detection of peritoneal. Each stage is further divided into substages, such as a, b, c, which indicate increasing amounts of tumour. The international federation of gynecologists and obstetricians figo has revised the staging of ovarian cancer. First, it was recognized that ovarian cancer is not a homogeneous disease, but rather a group of diseaseseach with different morphology and biological behavior. Although each persons cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated in much the same way. As a rule, the lower the number, the less the cancer has spread. Ovarian cancer stages range from stage i 1 through iv 4.
A new report from figos ijgo discusses updates to the ways in which cancers of the ovaries, fallopian tube and peritoneum are staged. In particular, it is now realized that cancer of ovary, fallopian tube, and peritoneum share similar. Tumor involves 1 or both ovaries with pelvic extension below the pelvic brim. Approximately 90% of ovarian cancers are carcinomas malignant epithelial tumors and, based on histopathology, immunohistochemistry, and. A higher number, such as stage iv, means cancer has spread more. Tnm figo categories stages m0 no distant metastasis m1 ivb distant metastasis including peritoneal spread, involvement of supraclavicular, mediastinal, or paraaortic lymph nodes, lung, liver, or bone am e ric an j o int co mmit te e o n can ce r. Approximately 90% of ovarian cancers are carcinomas malignant epithelial tumors and, based on histopathology. The most commonly adopted ovarian cancer staging system is the figo staging system.
Staging is necessary for explaining epidemiologic changes, defining the disease at presentation, and evaluating the overall impact of new therapies. Impact of the new figo 20 classification on prognosis of. Tumor involves 1 or both ovaries with cytologically or histologically confirmed spread to the peritoneum outside the pelvis andor metastasis to the retroperitoneal lymph nodes old new iiia microscopic metastasis beyond the pelvis. Figo committee on gynecologic oncology revised figo staging for carcinoma of the vulva, cervix, and endometrium. Staging criteria for cancer of the ovary, fallopian tube, and peritoneum stage i. The overall 5year relative survival currently is between 30% and 40%. The tumornodemetastasis tnm classification of the american joint committee on cancer ajcc and the international federation of gynecology and obstetrics figo classification for. In essence, it assigns patients to prognostic groups that require specific treatments. Imaging of ovarian cancer and the revised figo staging system ity of rmi for prediction of malignancy increases from 88% to 99% 31. Ajcc cancer staging manual 8th edition pdf free medical books. The tumornodemetastasis tnm and international federation of gynecology and obstetrics figo classifications for staging ovarian cancer. The revised 2014 figo staging system for epithelial ovarian cancer eoc included many changes of the previous system, particularly dividing figo stage iv in two subgroups. Data were extracted from 222 patients with initial stage iiia invasive.
Although cytoreduction is the best treatment for the management of advanced ovarian cancer, the are some factors that make it difficult to achieve. The revision by figo followed a series of meetings which were concluded in italy at the end of 2012. Tumor confined to ovaries or fallopian tubes t1n0m0 ia. Pathologic tnm and figo classification, staging of tumors of. The approved, new ovarian cancer staging went into effect on jan.
Cancer staging is a fundamental principle and one of the first and most important steps used to predict patient outcome as well as to plan the most appropriate treatment. Pathologic tnm and figo classification, staging of tumors of the ovary, fallopian tube and primary peritoneal carcinoma author. The revised figo staging incorporates ovarian, fallopian tube, and peritoneal cancer into the same system. Ovarian cancer stages and grades target ovarian cancer. The process of the proposed changes to the staging of ovarian, fallopian tube, and primary peritoneal cancer started three years ago under the leadership of the chair of the figo committee on gynecologic oncology, professor lynette denny. Cancer of the ovary, fallopian tube, and peritoneum berek 2018. A higher number, such as stage iv, means cancer has spread to other parts of the body. This editorial is written to make the readership aware of the recent changes that have been made by the international federation of gynecology and obstetrics figo in the staging classification of ovarian. On rectal examination, there is no cancer free space between the tumor and the. The staging system most commonly used for ovarian cancer is the international federation of gynecology and obstetrics figo system. Pdf on mar 3, 2018, e c nganga and others published imaging staging of ovarian cancer find, read and cite all the research you need on researchgate.
Pdf figos staging classification for cancer of the ovary. This editorial is written to make the readership aware of the recent changes that have been made by the international federation of gynecology and obstetrics figo in the staging classification of ovarian cancer and the reasoning behind those changes 1 x 1 prat, j. Over the past quarter of a century, several scientific developments have challenged traditional concepts in ovarian cancer. Jaime prat for the figo committee on gynecologic oncology1 article info keywords. First, it was recognized that ovarian cancer is not a homogeneous disease, but. Although ultrasound can be used for diagnosis, it is not the imaging. The process of the proposed changes to the staging of ovarian, fallopian tube, and primary peritoneal cancer started three years ago under the leadership of the chair of the figo committee on. Committee of figo in 2014 revised the staging of ovarian cancer. Ct is considered the best imaging modality for staging ovarian cancer. Although ultrasound can be used for diagnosis, it is not the imaging modality used to stage ovarian cancer. The american joint committee on cancer ajcc tnm classification and the international federation of gynecology and obstetrics figo staging system for germ cell tumors are. Figos staging classification for cancer of the ovary, fallopian tube. The 2 systems used for staging ovarian cancer, the figo international federation of gynecology and obstetrics. The revised 2014 figo staging system for epithelial.
Staging is very important because ovarian cancers have different prognoses at different stages and are treated differently. Figo staging, epithelial cancer of ovary definition of. First and foremost, staging provides patients with cancer and their physicians the critical benchmark and standards for defining prognosis, the likelihood of overcoming the cancer once diagnosed, and for determining the best treatment approach for the disease. The updated, revised figo staging system combines the classification for ovarian, fallopian tube and peritoneum cancer and is based on findings made mainly through surgical exploration, since operative findings allow doctors to determine the precise histologic diagnosis, stage and prognosis of the patient. Another discovery that influenced the new figo staging occurred in 2001, when patients with brca mutation breastovarian cancer syndrome undergoing riskreducing salpingooophorectomy rrso were found to have highgrade serous tubal intraepithelial carcinoma stic not in the ovary but in the fallopian tube and, particularly, in the fimbria.
Ovarian cancer, the revised figo staging system, and the role. Prognostic factors in earlystage ovarian cancer ecancer. The figo cancer report previously the figo annual report on the result of treatment in gynecologic cancer was launched at the figo world congress of gynecology and obstetrics in rome, italy, in. Ffdg pet fludeoxyglucose f 18 positron emission tomography pfs progression free survival ps performance status qoe quality of evidence qol quality of life rcog royal college of obstetricians and gynaecologists rct randomized controlled trial. Endometrial cancer stages range from stage i 1 through iv 4. International federation of gynaecology and obstetrics figo stage i ovarian cancer limited to the ovaries is diagnosed in approximately 20% to 33% of women with ovarian cancer in developed. These staging codes are also used in staging fallopian tube and peritoneal cancer which are treated in a similar way to ovarian cancer. Malignant germ cell tumors of the ovary follow the same staging system as epithelial ovarian and primary peritoneal cancers. Tumor involves 1 or both ovaries with cytologically or histologically confirmed spread to the peritoneum outside the. Results of repeat staging in apparent stage i and ii ovarian cancer initial stage no.
Nov 14, 2018 the american joint committee on cancer ajcc tnm classification and the international federation of gynecology and obstetrics figo staging system for germ cell tumors are listed below see tables 1 and 2. Fallopian tube cancer ovarian cancer peritoneal cancer staging introduction ovarian cancer is the seventh most common cancer diagnosis. Ffdg pet fludeoxyglucose f 18 positron emission tomography pfs progression free survival ps performance. Malignant cells in the ascites or peritoneal washings. May 23, 2015 staging is very important because ovarian cancers have different prognoses at different stages and are treated differently. Ovarian cancer is cancer of the ovaries, the eggreleasing and hormoneproducing organs of the female reproductive tract. Nov 10, 2014 ovarian cancer is the second most common gynecologic malignancy, endometrial cancer being the most common, but is the most common cause of death among women who develop a gynecologic malignancy. Ovarian cancer, the revised figo staging system, and the. Cancer staging is a core principle in understanding the severity of patients clinical condition, predicting the outcome, and planning adequate treatment. Another discovery that influenced the new figo staging occurred in 2001, when patients with brca mutation breastovarian cancer syndrome undergoing riskreducing salpingooophorectomy rrso. Although each persons cancer is unique, cancers with similar stages. Laparoscopy versus laparotomy for figo stage i ovarian cancer. We evaluated if classifying patients with eoc in figo stage iva and ivb has any prognostic implication. Updates on the staging and management guidelines on each sitespecific gynecological cancer, and.
Epithelial ovarian cancer is the fifth most common cancer among women. The figo cancer report previously the figo annual report on the result of treatment in gynecologic cancer was launched at the figo world congress of gynecology and obstetrics in rome, italy, in october 2012. Patients upstaged ia 37 16% ib 10 30% ic 2 0% iia 4 100% iib 38 39% iic 9 33% total 100 31% young rc et al. Data were extracted from 222 patients with initial stage iiia invasive epithelial ovarian cancer treated with primary surgery followed or not followed by adjuvant therapy, from 1 january 1980 to 31 december 2008, at the division of obstetrics and. The role of surgery in advanced epithelial ovarian cancer. Pdf imaging staging of ovarian cancer researchgate. Ovarian cancer is the seventh most commonly occurring cancer in women and the eighth most common cause of death from cancer in women in the world. Talk to your doctor if you have questions about staging. Ovarian, fallopian tube and peritoneal cancer staging. Apr 11, 2018 ovarian cancer stages range from stage i 1 through iv 4.
Since publicationof the last figo cervical cancer staging in 2009, considerable progress has been made in the use of imaging modalities to evaluate women with cervical cancer. Figos staging classification for cancer of the ovary. A higher number, such as stage iv, means cancer has spread to other parts of. Figo has recently revised the staging of ovarian cancer. Figo committee on gynecologic oncology revised figo staging. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Revised figo staging for carcinoma of the cervix uteri. It includes a revision of the stage iii patients and allotment to stage iiia1 is based on spread to the retroperitoneal lymph nodes without intraperitoneal dissemination, because an analysis of these patients indicates that their survival is significantly better than those who have. In stage i ovarian cancer, histologic grad ing is the most important factor influencing diseasefree survival 69, 71, 76. International federation of gynaecology and obstetrics figo stage i ovarian cancer limited to the ovaries is diagnosed in approximately 20% to 33% of women with ovarian cancer in developed countries maringe 2012 and diagnosis is usually made by accidental discovery at sonography, computerised tomography ct scanning or during laparoscopy.
Ovarian cancer staging radiology reference article. In general, ovarian cancer is a disease of the postmenopausal woman, with the highest incidence among patients ages 6574 year. Although cytoreduction is the best treatment for the management of advanced ovarian cancer, the are some factors that make it difficult to achieve complete cytoreduction in certain patients. Tnm figo categories stages m0 no distant metastasis m1 ivb distant metastasis including peritoneal spread, involvement of supraclavicular, mediastinal, or paraaortic lymph nodes, lung, liver, or bone am e ric an j o int co mmit te e o n can ce r financial support for ajcc 7th edition staging posters. Ovarian cancer is the fifth most common type of cancer in women and the fourth most common cause of cancer death in them. Figo committee on gynecologic oncology revised figo. Generally, the higher the stage number, the more the cancer has spread. Ct is considered the best imaging modality for staging ovarian. The purpose of this study was to identify the main prognostic factors in patients with earlystage epithelial ovarian cancer. Abridged republication of figos staging classification for. The international federation of gynecology and obstetrics figo ovarian cancer staging system was first published in 1973 and was revised in 1988 and 2014 1, 2. Ovarian cancer is the second most common gynecologic malignancy, endometrial cancer being the most common, but is the most common cause of death among women who develop a. The most common staging system for ovarian cancer is the figo system. The figo and tnm staging codes for ovarian cancer are listed below.
1319 492 399 858 874 906 186 1021 1445 11 1079 274 879 71 652 1234 1021 1134 103 595 276 904 565 298 13 1299 860 936 1133 1294 279 618 3 152 492