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Erschienen in:

01.10.2012 | Gynecologic Oncology

Comparison of prognosis in patients with endometrioid endometrial cancer staged IB in FIGO 1988 and 2009 classifications

verfasst von: Leszek Gottwald, Malgorzata Moszynska-Zielińska, Michal Spych, Jerzy Korczynski, Wieslaw Tylinski, Jaroslaw Szwalski, Robert Kubiak, Grazyna Pasz-Walczak, Janusz Sobotkowski, Jacek Suzin, Janusz Piekarski

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2012

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Abstract

Purpose

Since 2009 the new FIGO Staging System of endometrial cancer, which changed the previous FIGO 1988 Staging System, has been in use. The aim of the study was to compare prognosis in patients with endometrioid endometrial cancer at stage IB of the 2009 FIGO Staging System and of the 1988 FIGO Staging System.

Methods

We analyzed 173 patients: 108 patients (group A) at stage IB in FIGO 1988 Staging System, and 68 patients (group B) at stage IB in FIGO 2009 Staging System from 262 consecutive endometrioid endometrial cancer patients. The disease-free survival (DFS) and overall survival (OS) were compared between these groups.

Results

The DFS rate was 96.3 % in group A and it was 87.7 % in group B (p = 0.029). Relapses were observed in 12 patients (6.4 %) from 6 to 57 months (mean 28.1; SD = 14.6) after initial surgery, and occurred in four patients from group A (3.7 %) and eight patients from group B (12.3 %) (p = 0.032). The OS rate was 94.4 % in group A and it was 83.1 % in group B (p = 0.018). During follow-up, 17 patients (9.8 %) died: six patients from group A (5.6 %), and 11 patients from group B (16.9 %).

Conclusions

Stage IB in FIGO 2009 Staging System is associated with worse prognosis compared to stage IB according to FIGO 1988 classification. There seems to be a need to use exclusively the new FIGO 2009 classification worldwide to avoid therapeutic mistakes, which can be caused by diverse nomenclature.

Sivridis E (2004) Endometrial adenocarcinoma: an apostasy from early views. Gynecol Oncol 95:772–777PubMedCrossRef

Cirisano FD, Robboy SJ, Dodge RK, Bentley RC, Krigman HR, Synan IS, Soper JT, Clarke-Pearson DL (1999) Epidemiopathologic and surgicopathologic findings of papillary serous and clear cell endometrial cancers when compared to endometrioid carcinoma. Gynecol Oncol 74:385–394PubMedCrossRef

Kudela M, Pilka R, Lubusky M, Hejtmánek P, Dzubak P, Brychtova S (2011) Prognostic importance of selected molecular genetic immunohistochemical markers and DNA ploidy in endometrial cancer. Ceska Gynekol 76:194–199PubMed

Maneschi F, Ceccacci I, Perugini A, Pane C, Simeone A, Manicone A (2011) Endometrial cancer: prognostic significance of risk classification based on pre-intraoperative findings. Arch Gynecol Obstet. doi:101007/s00404-011-2004-9 PubMed

Odicino F, Pecorelli S, Zigliani L, Creasman WT (2008) History of the FIGO cancer staging system. Int J Gynaecol Obstet 101:205–210PubMedCrossRef

Benedet JL, Bender H, Jones H 3rd, Ngan HY, Pecorelli S (2000) FIGO staging classifications and clinical practice guidelines for gynaecological cancers. FIGO Committee on Gynecologic Oncology. Int J Gynaecol Obstet 70:209–262PubMedCrossRef

Shepherd JH (1989) Revised FIGO staging for gynaecological cancer. Brit J Obstet Gynaecol 96:889–892CrossRef

Pecorelli S (2009) Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 105:103–104PubMedCrossRef

Lewin SN (2011) Revised FIGO staging system for endometrial cancer. Clin Obstet Gynecol 54:215–218PubMedCrossRef

10.

Creasman W (2009) Revised FIGO staging for carcinoma of the endometrium. Int J Gynecol Obstet 105:109CrossRef

11.

Zaino RJ (2009) FIGO staging of endometrial adenocarcinoma: a critical review and proposal. Int J Gynecol Pathol 28:1–9PubMedCrossRef

12.

Korczynski J, Jesionek-Kupnicka D, Gottwald L, Piekarski J (2011) Comparison of FIGO 1989 and 2009 recommendations on staging of endometrial carcinoma: pathologic analysis and cervical status in 123 consecutive cases. Int J Gynecol Pathol 30:328–334PubMedCrossRef

13.

Abu-Rustum NR, Zhou Q, Iasonos A, Alektiar KM, Leitao MM Jr, Chi DS, Sonoda Y, Soslow R, Hensley M, Barakat RR (2011) The revised 2009 FIGO staging system for endometrial cancer: should the 1988 FIGO stages IA and IB be altered? Int J Gynecol Cancer 21:511–516PubMedCrossRef

14.

Lewin SN, Herzog TJ, Barrena-Medel NI, Deutsch I, Burke WM, Sun X, Wright JD (2010) Comparative performance of the 2009 international Federation of gynecology and obstetrics’ staging system for uterine corpus cancer. Obstet Gynecol 116:1141–1149PubMedCrossRef

15.

Fanning J (2001) Long-term survival of intermediate risk endometrial cancer (stage IG3, IC, II) treated with full lymphadenectomy and brachytherapy without teletherapy. Gynecol Oncol 82:371–374PubMedCrossRef

16.

Shumsky AG, Brasher PM, Stuart GC, Nation JG (1997) Risk-specific follow-up for endometrial carcinoma patients. Gynecol Oncol 65:379–382PubMedCrossRef

17.

Lukka H, Chambers A, Fyles A, Thephamongkhol K, Fung-Kee-Fung M, Elit L, Kwon J (2006) Adjuvant radiotherapy in women with stage I endometrial cancer: systematic review. Gynecol Oncol 102:361–368PubMedCrossRef

18.

Goudge C, Bernhard S, Cloven NG, Morris P (2004) The impact of complete surgical staging on adjuvant treatment decisions in endometrial cancer. Gynecol Oncol 93:536–539PubMedCrossRef

19.

Gretz HF 3rd, Economos K, Husain A, Lesser M, Kaplan E, Caputo TA, Reynolds RK, Johnston CM, Pearl ML, Roberts JA (1996) The practice of surgical staging and its impact on adjuvant treatment recommendations in patients with stage I endometrial carcinoma. Gynecol Oncol 61:409–415CrossRef

20.

Solhjem MC, Petersen IA, Haddock MG (2005) Vaginal brachytherapy alone is sufficient adjuvant treatment of surgical stage I endometrial cancer. Int J Radiat Oncol Biol Phys 62:1379–1384PubMedCrossRef

21.

Kwon JS, Mazgani M, Miller DM, Ehlen T, Heywood M, McAlpine JN, Finlayson SJ, Plante M, Stuart GC, Carey MS (2011) The significance of surgical staging in intermediate-risk endometrial cancer. Gynecol Oncol 122:50–54PubMedCrossRef

22.

Nout RA, Smit VT, Putter H, Jűrgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, Mens JW, Slot A, Kroese MC, van Bunningen BN, Ansink AC, van Putten WL, Creutzberg CL (2010) Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomized trial. Lancet 375:816–823PubMedCrossRef

23.

National Comprehensive Cancer Network (2009) Clinical practice guidelines in oncology V2 2009. http://www.nccn.org/professionals/physiciangls/PDF/uterine.pdf

24.

Greven KM, Lanciano RM, Herbert SH, Hogan PE (1991) Analysis of complications in patients with endometrial carcinoma receiving adjuvant irradiation. Int J Radiat Oncol Biol Phys 21:919–923PubMedCrossRef

25.

Irwin C, Levin W, Fyles A, Pintilie M, Manchul L, Kirkbride P (1998) The role of adjuvant radiotherapy in carcinoma of the endometrium: results in 550 patients with pathologic stage I disease. Gynecol Oncol 70:247–254PubMedCrossRef

26.

Cooke EW, Pappas L, Gaffney DK (2011) Does the revised international federation of gynecology and obstetrics staging system for endometrial cancer lead to increased discrimination in patient outcomes? Cancer. doi:10.1002/cncr.26030

27.

Jordan LB, Al-Nafussi A (2002) Clinicopathological study of the pattern and significance of cervical involvement in cases of endometrial adenocarcinoma. Int J Gynaecol Cancer 12:42–48CrossRef

Titel: Comparison of prognosis in patients with endometrioid endometrial cancer staged IB in FIGO 1988 and 2009 classifications
verfasst von: Leszek Gottwald
Malgorzata Moszynska-Zielińska
Michal Spych
Jerzy Korczynski
Wieslaw Tylinski
Jaroslaw Szwalski
Robert Kubiak
Grazyna Pasz-Walczak
Janusz Sobotkowski
Jacek Suzin
Janusz Piekarski
Publikationsdatum: 01.10.2012
Verlag: Springer-Verlag
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 4/2012
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-012-2378-3

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Comparison of prognosis in patients with endometrioid endometrial cancer staged IB in FIGO 1988 and 2009 classifications