FIGO 2018 Staging for Cervical Cancer: Influence on Stage Distribution and Outcomes in the 3D-Image-Guided Brachytherapy Era
FIGO 2018 Staging for Cervical Cancer: Influence on Stage Distribution and Outcomes in the 3D-Image-Guided Brachytherapy Era
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DOI：
10.3390/cancers12071770
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发表时间：
2020-07-01
期刊：
影响因子：
5.2
通讯作者：
Ohno, Tatsuya
中科院分区：
文献类型：
--
作者：
Tomizawa, Kento;Kaminuma, Takuya;Ohno, Tatsuya
近年来，三维图像引导的近距离放射治疗(3D-IGBT)的广泛应用显著改善了宫颈癌的放射治疗效果。2018年，国际妇产科联合会(FIGO)宫颈癌分期系统进行了修订。然而，修订对3D-IGBT治疗宫颈癌的分期分布和结果的影响仍不清楚。在这里，我们回顾分析了221例宫颈鳞癌患者，采用3D-IGBT(中位随访期，60个月)进行最终放射治疗。比较了2009年和2018年方案的阶段分布和结果。52.9%的患者发生分期转移。被2018年标准归类为IIIC(R)阶段的患者迁移比例最高(43.8%)，主要来自2009年IIB和IIIB阶段。2009年和2018年的方案在对IB-IVA期患者的5年总生存期(OS)和5年无进展生存期(PFS)进行分层方面显示出类似的表现。2018年的标准有效地将5年期操作系统和PFS分成了第三阶段。IIIC1(R)期患者的5年OS和PFS因肿瘤T期而异。这些数据为修订后的2018年FIGO分期系统在3D-IGBT时代宫颈癌临床管理中的应用提供了证据。
Recent widespread use of three-dimensional image-guided brachytherapy (3D-IGBT) has improved radiotherapy outcomes of cervical cancer dramatically. In 2018, the International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer was revised. However, the influence of the revisions on the stage distribution and outcomes of cervical cancers treated with 3D-IGBT remains unclear. Here, we retrospectively analyzed 221 patients with cervical squamous cell carcinoma treated with definitive radiotherapy using 3D-IGBT (median follow-up, 60 months). The stage distribution and outcomes were compared between the 2009 and 2018 schemas. Stage migration occurred in 52.9% of the patients. Patients classified with the 2018 criteria as stage IIIC(r)had the highest proportion (43.8%) of migration, and were mainly from the 2009 stages IIB and IIIB. The 2009 and 2018 schemas showed comparable performance at stratifying 5-year overall survival (OS) and 5-year progression-free survival (PFS) for patients in stages IB-IVA. The 2018 criteria effectively stratified 5-year OS and PFS in the stage III substages. The 5-year OS and PFS for stage IIIC1(r)patients varied according to tumor T stage. These data provide evidence for the utility of the revised 2018 FIGO staging system in the clinical management of cervical cancers in the 3D-IGBT era.