| Popis: |
OBJECTIVE The purpose of the study was to compare FIGO 2009 and 2018 uterine cervical carcinoma staging systems in terms of patient distribution and efficacy in predicting treatment outcome in patients treated with surgery and adjuvant radiotherapy (RT)+/-concomitant chemotherapy (CT). METHODS The records of 184 uterine cervical cancer patients treated with post-operative RT/RCT from 2007 to 2017 were retrospectively reviewed. Surgical procedure was in the form of Wertheim surgery in 96 patients (52%) and pelvic lymph node dissection was performed in 32 patients (17.5%). One hundred and sixty-six patients (87.5%) received both external RT and intracavitary brachytherapy, and 23 (12.5%) patients were treated only with external RT. RESULTS The median follow-up time was 61.5 months (range, 8-132 moths). One hundred and fifty-one (82%) patients were alive, and 144 (94%) of these were free of disease at the time of this analysis. The median time for locoregional failure and distant metastasis were 25 months (range, 8-88 months) and 38 months (range, 12-118 months). Stage migration was recorded in 130 patients (70.7%) in our series when the International Federation of Gynecology and Obstetrics (FIGO) 2018 staging system was used. The most remarkable stage migration was detected for Stage I patients. A total of 119 (64.6%) patients with Stage I showed stage migration. Five-year locoregional control, disease-free survival, disease-specific survival, and overall survival rates were 91%, 88%, 91%, and 83%, respectively. CONCLUSION The updated FIGO staging system for invasive cervical cancer incorporates imaging and pathological findings. Our results suggest us that the major improvement of 2018 staging system for uterine cervical carcinoma is that it produced better discrimination in terms of survival outcome in patients with lymph node metastases both pelvic and para-aortic. |
