Download - FIGO Staging: Gynaecological Oncology
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FIGO Staging:
Gynaecological Oncology
Andy NordinConsultant Gynaecologist / Subspecialist Gynae Oncologist
East Kent Gynaecological Oncology Centre, UKHon. Senior Lecturer University College LondonNational Lead for Gynaecology NHS Improvement – Cancer
Chair: National Cancer Intelligence Network Gynaecology Clinical Reference Group
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FIGO Staging• why FIGO?• which FIGO?• Surgical vs Clinical staging• limitation of FIGO Cervical staging• MDT ascertainment of FIGO stage• national variation
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1929: League of Nations Classification for Cervical Cancer Various refinements + uterine classification 1953: FIGO took responsibility 1961: first FIGO staging systems
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First collaboration betweenFIGO: International Federation Gynecology & Obstetrics andIGCS: International Gynecologic Cancer Society
2000
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Which FIGO staging system
2000 (republished 2009)
OvaryFallopian TubeVagina
Trophoblastic Disease
2009CervixEndometrialVulva
Sarcoma
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When will FIGO ovarian cancer staging change?
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Cervical Staging
Clinical FIGO Stage 1b ≠ TNM T1N0M0o 3cm tumour confined to cervix on imaging / EUA: FIGO stage 1B1 3 scenarios:o radical hysterectomy, negative nodes: FIGO stage 1B1, no adjuvant
treatment – 5 year survival 85%o radical hysterectomy, positive nodes: FIGO stage 1B1, adjuvant
chemoradiotherapy – 5 year survival 35-40%
o primary chemoradiotherapy: FIGO stage 1B1, unknown nodal status
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Role of MDT in assigning FIGO stage
FIGO staging requires:• clinical findings• histology
• biopsy / primary surgery / staging procedures
• imaging• u/s, CT, MRI, PET
• surgical / operative findings• eg tumour > 2cm mets – may not be apparent on histo
may change as more information collected: definitive FIGO stage assigned by MDT at that time MUST be the one collected by registries
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National Variation
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Staging Data Cervix: variable
Ovary coverage limited to two ECRIC / NYCRIS
Uterine coverage limited to two ECRIC / NYCRIS
Questions: how are cases identified? how are ICD10 codes assigned? how / when is collected FIGO data generated? how can we ensure that MDT assigned FIGO stage is
collected nationally?