19.2 C
Munich
Friday, March 29, 2024

FIGO classification – cancer stage

Must read

Gynecological cancers are among the most commonly diagnosed malignancies in women worldwide. In Poland, the number of diagnosed cases of ovarian cancer, cervical cancer, endometrial cancer and other types of cancer in women is systematically increasing.

  • Cervical cancer – cancer staging according to FIGO criteria
  • The first level of the FIGO classification for cervical cancer distinguishes between microinvasive staging (IA1 and IA2) and clinical staging (IB).
  • FIGO stage II cervical cancer is distinguished by stages IIA1 and IIA2 and stage IIB.
  • Grade III FIGO refers to neoplastic changes affecting the lymph nodes.
  • FIGO staging system for ovarian, fallopian tube and peritoneal cancer
  • Level I of the FIGO classification of ovarian, fallopian tube and peritoneal cancer includes stages of the disease – IA, IB and IC
  • FIGO stage II for ovarian, fallopian tube and peritoneal cancer includes two stages of the disease – IIA and IIB
  • III stage according to FIGO in cancer of the ovaries, fallopian tube and peritoneum includes 4 stages of the disease – IIIA1, IIIA2, IIIB and IIIC.
  • FIGO stage IV in ovarian, fallopian tube and peritoneal cancer is a tumor that gives distant metastases. There are two stages of the disease – IVA and IVB.

Malignant neoplasms and benign tumors that can develop into cancer are a serious problem of modern oncology. In women, gynecological cancer is one of the most frequently diagnosed diseases. Often they lead to premature death, which is associated with the detection of the disease at an advanced stage. Every year the number of deaths from cancer of the female genital organs increases. At the stage of diagnosis of malignant neoplasms, FIGO staging is used.

Ovarian cancer, cervical cancer, endometrial cancer and other types of cancer of the female genital organs can be detected in the early stages of the disease if the woman does not forget about screening tests.

A two-handed gynecological examination should be carried out once a year for preventive purposes. It is also necessary to perform an ultrasound examination and a cytological examination, which can detect pathologically altered cells before the cancer begins to show symptoms. Laboratory tests, such as genetic tests and tests for the presence of tumor markers in the blood, are also used to prevent cancer of the reproductive organs.

Over the years, experts have noted an increase in the number of diagnosed gynecological cancers and the number of deaths caused by them, which can be avoided with a systematic gynecological examination.

Although female cancers are most often diagnosed in middle-aged and older women, there has been a marked increase in the incidence among younger women. Some cancers are genetic and run in families. Women with a genetic risk of developing cancer should have more frequent checkups. The detection of high-grade cancer at an advanced stage is associated with a high risk of death, since distant metastases often occur in the body.

At the stage of gynecological cancer diagnosis, various tests are performed to determine the type of cancer, as well as the damage that the disease has caused to the body. The FIGO classification is used to assess the stage of cancer. It was created and is being updated by the International Federation of Obstetricians and Gynecologists. The FIGO cancer staging system allows comparison of different cases and prognosis, and indicates the best treatment.

The FIGO classification is used, for example. at the staging stage of cervical cancer, ovarian cancer, fallopian tube cancer and peritoneal cancer.

Cervical cancer – cancer staging according to FIGO criteria

The female reproductive organ is affected by various types of cancer. One of them is cervical cancer, which is diagnosed annually in about 2.5 thousand Polish women. Most often, the disease is diagnosed in women over 60 years old, but in some cases it is also diagnosed in women in perimenopause.

The main cause of cervical cancer is infection with HPV types 16 and 18 and other oncogenic strains of the virus. The risk of infection also increases long-term use of hormonal contraception, very early onset of sexual activity, a large number of pregnancies and obesity. Diseases that cause immune disorders, untreated intimate infections and heavy smoking also affect the risk of infection.

Symptoms that may indicate cervical cancer include: abnormal menstrual bleeding, bleeding and spotting between periods, bleeding after intercourse, and pelvic pain. A symptom of cervical cancer can also be heavy discharge, as well as bleeding and spotting after menopause.

The current FIGO classification of cervical cancer includes three stages of cancer. Each of them is divided into stages of the disease.

The first level of the FIGO classification for cervical cancer distinguishes between microinvasive staging (IA1 and IA2) and clinical staging (IB).

The degree of IA1 and IA2 varies depending on the depth of invasion of the connective tissue stroma. Grade IA1 – infiltrate less than 3 mm; degree IA2 – infiltrate 3-5 mm deep.

Stage IB is clinically obvious forms of cancer. At the same time, they distinguish:

  • stage IB1, in which the tumor is less than 2 cm,

  • stage IB2, in which the diameter of the tumor ranges from 2-4 cm,

  • stage IB3, when the tumor is greater than or equal to 4 cm.

In the case of radiologically or surgically confirmed involvement of the lymph nodes, the disease progresses to IIIC.

FIGO stage II cervical cancer is distinguished by stages IIA1 and IIA2 and stage IIB.

In stages IIA1 and IIA2, there is no parametrium lesion, and in stage IIB, there is parametrium, but the infiltrate does not extend to the walls of the uterus. Stage IIA1 – tumor less than 4 cm in size; stage IIA2 – the tumor is greater than or equal to 4 cm.

In the case of radiologically or surgically confirmed involvement of the lymph nodes, the disease progresses to IIIC.

Grade III FIGO refers to neoplastic changes affecting the lymph nodes.

In this case, stage IIIC1 – metastases to the ilio-obturator lymph nodes and stage IIIC2 – metastases to the para-aortic lymph nodes are isolated.

FIGO staging system for ovarian, fallopian tube and peritoneal cancer

Ovarian cancer can develop in young women, as well as in perimenopausal and postmenopausal women. The disease causes non-specific symptoms that are often underestimated. Symptoms of ovarian cancer include chronic fatigue, digestive complaints, feeling full after eating, abdominal pain, abnormal vaginal bleeding, and bladder pressure. As a result of an increase in the mass of the tumor, the circumference of the abdomen begins to increase rapidly.

The risk of developing ovarian cancer is increased by hormonal imbalances that make it necessary to stimulate the ovaries. Women who do not have children or who have given birth after 35 years, as well as women with obesity, are more likely to get sick.

Treatment of advanced ovarian cancer is very difficult and often ineffective. In this case, systematic ultrasound and gynecological examinations are crucial for early diagnosis of the disease.

The FIGO classification of ovarian, fallopian tube and peritoneal cancer includes four stages of the disease, which have been divided into separate stages.

Stage I of the disease is diagnosed when a tumor is found that is limited to the ovary or fallopian tube.

Level I of the FIGO classification of ovarian, fallopian tube and peritoneal cancer includes stages of the disease – IA, IB and IC

IA Stadium:

  • the tumor is limited to 1 ovary or fallopian tube (the integrity of the tumor capsule is intact)

  • no changes on the surface of the ovary or fallopian tube

  • absence of cancer cells in fluid or washings from the abdomen or fallopian tubes

IB Stadium:

  • tumor confined to 2 ovaries or fallopian tubes (integrity of tumor capsule or tumors)

  • no changes on the surface of the ovaries or fallopian tubes

  • absence of tumor cells in the fluid or washings from the abdominal cavity

Stage IC is a tumor limited to 1 or 2 ovaries or 2 fallopian tubes with:

  • IC1 with intraoperative damage to the integrity of the tumor capsule

  • IC2 with impaired integrity of the tumor capsule before surgery

  • IC3 by the presence of a tumor on the surface of the fallopian tube or ovary, tumor cells in the fluid or washings from the abdominal cavity

FIGO stage II for ovarian, fallopian tube and peritoneal cancer includes two stages of the disease – IIA and IIB

In this case, the tumor is limited to the ovaries or fallopian tubes with involvement of the pelvic organs below the plane of entry into the pelvis. Primary peritoneal cancer may also be present.

Stage IIA is diagnosed when the uterus is affected or there are implants on the surface of the uterus, fallopian tubes, or fallopian tubes.

Stage IIB is diagnosed when other pelvic organs are affected.

III stage according to FIGO in cancer of the ovaries, fallopian tube and peritoneum includes 4 stages of the disease – IIIA1, IIIA2, IIIB and IIIC.

FIGO stage III for ovarian, fallopian tube and peritoneal cancer:

  • cancer affecting 1 or 2 ovaries

  • cancer affecting 1 or 2 fallopian tubes

  • primary peritoneal cancer with metastases to the peritoneum outside the pelvis and/or metastases to the retroperitoneal lymph nodes.

Stage IIIA1 – Cytologically or histologically confirmed tumor metastases only in the retroperitoneal lymph nodes.

Stage IIIA2 – microscopic metastases to the peritoneum outside the pelvis (above the entrance to the pelvis) without metastases to the retroperitoneal lymph nodes.

IIIB stage – macroscopic metastases in the peritoneum outside the pelvis with a diameter of less than or equal to 2 cm with metastases in the retroperitoneal lymph nodes or without them (including involving the capsule of the liver and spleen without infiltration of their parenchyma).

Stage IIIC – macroscopic metastases in the peritoneum outside the small pelvis with a diameter of more than 2 cm in greatest dimension with or without metastases in the retroperitoneal lymph nodes (including involving the capsules of the liver and spleen without infiltration of their parenchyma).

FIGO stage IV in ovarian, fallopian tube and peritoneal cancer is a tumor that gives distant metastases. There are two stages of the disease – IVA and IVB.

Stage IVA – pleural effusion with cytologically confirmed tumor cells.

Stage IVB – metastases to the parenchyma of the liver and spleen and metastases to organs outside the abdominal cavity (including inguinal and extra-abdominal lymph nodes).

Source: Practical gynecology and perinatology 2019 vol. 4, no. 4, pp. 149-154, Oncology in clinical practice 2015, vol. 11, no. 3, 129-134.

Source: Wprost

More articles

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Latest article