Neuerungen beim FIGO-Staging gynäkologischer Malignome 2009

Abstract

The aim of FIGO staging is to compare the treatment results of gynecological malignancies worldwide. At the end of 2009, a revised staging system was published by the FIGO staging committee. For cervical cancer, stage II a was subdivided into stage II a1 and II a2, based on the diameter of the tumor (≤ 4 cm versus > 4 cm, respectively). For endometrial cancer, only two substages, I a and I b, were established for stage I disease. Tumors with no invasion or invasion of less than 50 % of the myometrium are classified as stage I a. Only tumors with cervical stromal involvement are classified as stage II disease. Positive peritoneal cytology alone no longer classifies a patient as having stage III disease. Staging for endometrial cancer can also be used for carcinosarcomas (malignant mixed Muellerian tumor, MMMT). For the first time, a separate staging for the other uterine sarcomas has been established. For leiomyosarcoma, the subdivision of stage I in I a and I b depends on the tumor size ( 5 cm, respectively). Cervical involvement alone does not change the classification. For endometrial stromal sarcoma and uterine adenosarcoma, the prognostically relevant degree of myometrial invasion has been included in the classification. Especially with regard to inguinofemoral lymph node involvement in stage III vulvar cancer, a differentiated staging has been established. The size of metastatic lesions as well as their extracapsular growth have to be stated in order to classify tumors adequately (FIGO stages III a-III c). The future will show whether the necessary diagnostic standard can be maintained internationally.