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From FIGO-2009 to FIGO-2018 in women with early-stage cervical cancer; Does the revised staging reflect risk groups?
Sponholtz, Sara Elisabeth; Mogensen, Ole; Hildebrandt, Malene Grubbe; Schledermann, Doris; Parner, Erik; Markauskas, Algirdas; Frøding, Ligita Paskeviciute; Fuglsang, Katrine; Holm, Jorun; Bjørnholt, Sarah Marie; Jensen, Pernille Tine.
Afiliación
  • Sponholtz SE; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark; Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark; OPEN, Open Patient data Explorative Network, Odense University Hospital, Region of Southern Denmark, Denm
  • Mogensen O; Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
  • Hildebrandt MG; Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark; Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark; Center for Innovative Medical Technology (CIMT), Odense University Hospital and University of Southern Denmark, Od
  • Schledermann D; Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark; Department of Clinical Pathology, Odense University Hospital, Odense, Denmark.
  • Parner E; Deparment of Public Health, Aarhus University, Aarhus, Denmark.
  • Markauskas A; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark.
  • Frøding LP; Department of Gynecology, Copenhagen University Hospital, Denmark.
  • Fuglsang K; Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark.
  • Holm J; Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
  • Bjørnholt SM; Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
  • Jensen PT; Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark; Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
Gynecol Oncol ; 163(2): 281-288, 2021 11.
Article en En | MEDLINE | ID: mdl-34503847
OBJECTIVES: We aimed to evaluate if the revised staging according to FIGO-2018 in early-stage cervical cancer correctly predicts the risk for nodal metastases. METHODS: We reallocated 245 women with early-stage cervical cancer from FIGO-2009 to FIGO-2018 stages using data from a national, prospective cohort study on sentinel lymph node (SLN) mapping. We used univariate and multivariate binary regression models to investigate the association between FIGO-2018 stages, tumor characteristics, and nodal metastases. RESULTS: Stage migration occurred in 54.7% (134/245) (95% CI 48.2-61.0), due to tumor size or depth of invasion (71.6%, 96/134) and nodal metastases (28.4%, 38/134). Imaging preoperatively upstaged 7.3% (18/245); seven had nodal metastatic disease on final pathology. Upstaging occurred in 49.8% (122/245) (95% CI 43.4-56.2%) and downstaging to FIGO-2018 IA stages in 4.9% (12/245) (95% CI 2.6-8.4). The tumor size ranged from 3.0-19.0 mm in women with FIGO-2018 IA tumor characteristics, and none of the 14 women had nodal metastases. In multivariate analysis, risk factors significantly associated with nodal metastases were FIGO-2018 ≥ IB2 (RR 5.01, 95% CI 2.30-10.93, p < 0.001), proportionate depth of invasion >2/3 (RR 1.88, 95% CI 1.05-3.35, p = 0.033), and lymphovascular space invasion (RR 5.56, 95% CI 2.92-10.62, p < 0.001). CONCLUSIONS: The FIGO-2018 revised staging system causes stage migration for a large proportion of women with early-stage cervical cancer. Women who were downstaged to FIGO-2018 IA stages did not have nodal metastatic disease. The attention on depth of invasion rather than horizontal dimension seems to correctly reflect the risk of nodal metastases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Cuello Uterino / Cuello del Útero / Metástasis Linfática Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Gynecol Oncol Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Cuello Uterino / Cuello del Útero / Metástasis Linfática Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Gynecol Oncol Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos