At most institutions, the clinical use of mri remains limited to specific clinical questions and selected patients. We discuss treatment for endometrial cancer including chemotherapy, radiation, and hormones. Incidence of endometrial cancer is on the rise with a lifetime risk of approximately 3%. Endometrial cancer is the most common cancer of the organs of the female reproductive system. The last revision of the international federation of obstetricians and gynecologists figo staging of uterine corpus tumors was in 1988, and it represented the transition from a clinical to a surgicopathologic system. This stage is not included in the figo staging system.
In the european union, over 88,000 women are diagnosed with an endometrial cancer each year. Imaging of endometrial and cervical cancer springerlink. Cancer of the corpus uteri, typically referred to as endometrial cancer, arises from the epithelial lining of the uterine cavity. Predictors of postoperative overall and severe complications after surgical treatment for endometrial cancer. 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. Endometrial cancer early detection, diagnosis, and staging 1. This system allows the use of chest radiographs, examination under anesthesia with bimanual and rectovaginal examination, cystoscopy andor proctoscopy in patients with urinary or rectal symptoms, and intravenous pyelogram to evaluate for hydronephrosis. Key changes include simplification of stage i disease and removal of cervical mucosal invasion as a distinct stage. The first rules for classification and staging of female genital cancers adopted by the.
Analysis of 41,120 cases of endometrial cancer figo stage histological type clear cell, leiomyosarcoma, and carcinosarcoma were all found to have poorer prognosis. Significant changes have been made to the 2009 figo staging system for endometrial cancer, which has important implications for radiologists. Staging is a way to describe the size of the cancer and whether it has spread to other parts of the body. Endometrial cancer staging has changed over time to a surgicopathologic.
The 2 systems used for staging endometrial cancer, the figo international federation of gynecology and obstetrics system and the american joint committee on cancer tnm staging system are basically the same. Mr staging accuracy for endometrial cancer based on the new. Cervix, uterine, vulva international gynecologic cancer society. Intravaginal brachytherapy in figo stage i lowrisk. Pdf cancers of the uterine corpus and cervix are the most common gynecologic malignancies worldwide. The figo staging system recently underwent significant revision, which has.
Between january 2005 and may 2009, 199 women underwent surgery due to endometrial cancer. The stage provides a common way of describing the cancer, enabling doctors to work together to plan the best treatments. Accurate staging of cervical and endometrial cancer is essential to determine the correct treatment approach. Robles flores, aida mota garcia, dolores gallardo rincon. Endometrial cancer early detection, diagnosis, and staging cancer.
Jun 27, 2012 a total of 355 patients with endometrial cancer, who underwent complete surgical staging, were enrolled. Unlike cervical cancer, it is currently not a screenedfor cancer in the uk, and it is therefore important that doctors maintain a high index of suspicion in order to pick it up as early as possible. Preoperative imaging is needed for evaluation of local extent and detection of distant metastases in order to guide treatment planning. The uterus is the hollow, pearshaped pelvic organ where fetal development occurs.
This article discusses the risk factors, symptoms, and diagnosis of the most common type of endometrial cancer, called endometrioid endometrial cancer. Figo staging system and different guidelines acknowledge the benefits of mri staging. Myometrial invasion in the 1998 figo staging criteria, stage ia referred to disease within the endometrium, but with preservation of the junctional zone and no myometrial. Figo staging in vulval and endometrial cancer poliklinika harni. Histopathologic findings were used as a standard of reference. Histologic grade grade 1, 2 vs grade 3 lymph node status stage 3 age at diagnosis race were all prognostic factors mortality higher. Figo staging system for endometrial cancer stage ii endometrial cancer in a 64yearold woman. May 28, 2019 imaging plays a central role in the 2018 international federation of gynecology and obstetrics staging system for uterine cervical cancer. Revised figo staging for endometrial cancer south afr j gynaecol oncol 2010 vol 2 no 2 revised figo staging for endometrial cancer cancer staging is one of the fundamental activities in oncology and is of pivotal importance to the modern management of cancer patients. Endometrial cancer is a common oestrogendependent gynaecological cancer which tends to affect older women.
They both stage classify this cancer based on 3 factors. Mr imaging assessment of endometrial cancer is discussed in terms of imaging protocol. Radiological evaluation, based on transvaginal ultrasound, mr and ct, can. The value of mr imaging in staging endometrial and cervical carcinoma is discussed with emphasis on its effect on determining prognosis and. Pitfalls in cervical and endometrial cancer staging. In some cases, imaging scans can show if the cancer has spread, but it is often not possible to be sure of the stage until after surgery. Endometrial carcinoma staging radiology reference article. Pdf endometrial cancer is the most commonly diagnosed gynecologic malignancy in the united states. Figo committee on gynecologic oncology revised figo staging. To be able to stage vulval and endometrial cancer once the histopathology is available. Endometrial cancer can occur at any age, although it is much more common in women who have been through menopause when monthly periods stop. Endometrial cancer is a great concern in industrialized nations, where it is the most common gynecologic cancerwith incidence increasing every year.
Endometrial cancer is the most common gynaecologic malignancy in developed countries and its incidence is increasing. Mar 20, 2020 endometrial cancer is a type of cancer that begins in the uterus. Role of mri in staging and followup of endometrial and. In endometrial cancer, mri is reliable in identifying myometrial and cervical invasion and extrauterine disease, thereby informing preoperative surgical planning. Magnetic resonance imaging mri has emerged as the most widely used technique in the management of women with gynaecological cancer. Endometrial carcinoma staging allows appropriate treatment options to be considered and enables greater prognostic accuracy for endometrial carcinoma. The revised 2009 figo staging system for endometrial cancer. Tumor size and morphology as predictors of nodal status and recurrence in endometrial cancer. We sought to describe the overall survival os of women with stage i endometrial cancer and examine how the estimated stagespecific os is altered in the 2009 system. Consequently, all data and evidence for management of endometrial cancers are available on the basis of. The figo staging system recently underwent significant revision, which has important. Its epidemiology, clinical management and new research into future treatments is addressed in figo s updated cancer report 2018, published in the international journal of gynecology and obstetrics.
We compared the surgical stages and survival by figo 1988 staging system with those by figo 2008 staging system. The revised 2009 figo staging for endometrial cancer 2009 figo staging modifications the 4 main modifications to the 1998 figo staging criteria are as follows. The revised 2009 figo staging system for endometrial cancer included many changes over the 1988 system, particularly for stage i subgroups. Endometrial cancer begins in the layer of cells that form the lining endometrium of the uterus. Some early cancers may have signs and symptoms that can be noticed, but thats not always the case. Cervix uteri cancer staging 7th edition primary tumor t tnm figo categories stages tx primary tumor cannot be assessed cannot be assessedt0 no evidence of primary tumor tis carcinoma in situ preinvasive carcinoma t1 i cervical carcinoma confined to uterus extension to corpus should be disregarded. Figos staging classification for cancer of the ovary. Publication of this supplement was supported by figo funding to the figo committee for gynecologic oncology. The revision calls for a more precise measurement of primary tumor size, best assessed with imaging. Notably, in cases of endometrial and cervical cancer, mri offers the best diagnostic accuracy for staging and assessing lymphadenopathies, defining advanced disease, planning radiation ports, monitoring treatment response, and posttreatment surveillance to detect recurrence 1, 2. The revised figo staging system for uterine malignancies. Ajcc 7th edition 2009 corresponds to updated figo staging 2009 figo 2009 pmid 19345353 revised figo staging for carcinoma of the endometrium. In each patient, an endometrial cancer was staged using mr findings based on the old figo staging system and then repeated according to the new figo staging system for comparison. For uterine cancer, the staging system developed by the international federation of obstetrics and gynecology figo is used.
Jun 19, 2018 the national comprehensive cancer network nccn guidelines endorse universal immunohistochemistry ihc or microsatellite instability msi testing, regardless of family history, on all individuals diagnosed with colorectal or endometrial cancers to identify which patients should have genetic testing for lynch syndrome. Revised figo staging for carcinoma of the cervix uteri. Staging staging can be based on the tnm or figo system. Pdf the revised figo staging system for uterine malignancies. American joint committee on cancer staging manual, 7th edition, edge sb, byrd dr, compton cc, et al eds, springer, new york 2010.
Am e ric an j o int co mmit te e o n can ce r cervix uteri. If you get a diagnosis of uterine cancer, your doctor may tell you what stage it is. Its a way to figure out how advanced your cancer is and what kind of treatment works best before your doctor. This staging now applies only to endometrial carcinomas and there is now a separate staging for uterine sarcomas. Endometrial cancer is the fourth most common cancer in women with an estimated 46,470 new diagnoses and over 8000 deaths in 2011. Revision of figo surgical staging in 2009 for endometrial. In europe, 1 to 2 in every 100 women will develop endometrial cancer at some point in their life. Revised figo staging for endometrial carcinoma a pictorial. I do hope that despitethe shortcomings a cancer staging inevitably has, we are indeed committed to provide better guidance to physicians involved in the. Oct 11, 2018 the figo committee for gynecologic oncology is pleased to present the third edition of the figo cancer report. Correct staging is a cornerstone in cancer treatment.
New revised figo 2008 staging system for endometrial cancer. Endometrial and cervical cancer are the most common gynecologic malignancies in the world. Endometrial cancer early detection, diagnosis, and staging. Pdf pitfalls in cervical and endometrial cancer staging. Since 2012, this report has been presented triennially in the current format, which aims to present the state of the art management of gynecological cancers in our endeavor to ensure women worldwide receive an acceptable standard of care. Staging for vaginal cancer is based on clinical evaluation according to the figo system. Radiation oncologyendometriumstaging wikibooks, open. We have evaluated if the revision improved stratification with respect to prognosis in a large prospective multicenter setting. Endometrial cancer symptoms and causes mayo clinic.
The purpose of the study was to compare postoperative vaginal irradiation with surgery alone in lowrisk international federation of gynecology and obstetrics figo stage iaib endometrial carcinoma. The study was a prospective, randomized trial of 645 evaluable lowrisk endometrial carcinoma patients from 6 european gynecologic cancer centers. Endometrial cancer is sometimes called uterine cancer. Doctors assign the stage of endometrial cancer using the figo. The international federation of gynecology and obstetrics figo staging system was first established in.
Firstlevel treatment, if no contraindicated, is based on surgery. The following is the consensus agreement that resulted from these efforts and represents new criteria for staging of these gynecologic cancer table 1. Revised figo staging for carcinoma of the vulva, cervix, and endometrium. Grading describes how the cancer cells look under a microscope compared to normal cells and how aggressive they may be.