open access

Vol 11, No 3 (2015)
Review paper
Published online: 2015-07-29
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The new FIGO staging system for ovarian, fallopian tube and primary peritoneal cancer — 2014 update

Kamil Zalewski, Marcin Misiek, Stanisław Góźdź, Mariusz Bidziński
Onkol. Prak. Klin 2015;11(3):129-134.

open access

Vol 11, No 3 (2015)
REVIEW ARTICLES
Published online: 2015-07-29

Abstract

Goals of each cancer staging system are similar: it should give evidence about the prognosis of the patient, assist the clinician to plan appropriate treatment, allow for evaluation and comparison of treatment results in different centers and finally contribute to a deeper recognition of malignancy nature. The classification system should also meet three criteria: it should be credible, evidence-based and applicable in clinical practice. During recent years paramount changes have occurred in the pathogenesis of ovarian cancer and recent clinical studies have identified new prognostic factors. Therefore the last change in the classification of ovarian tumors in women was made at the beginning of 2014 and for the first time there were also included fallopian tube and primary peritoneal cancers. The main changes in the updated classification of cancer of the ovary, fallopian tube and the peritoneum are based on dividing the stage IC into three groups including surgical damage to the capsule of the tumor, tumor capsule rupture before the operation and the presence of malignant cells in the peritoneal fluid. Stage IIC has been omit ted. It was also considered that the presence of metastases limited to lymph nodes is a factor of better prognosis than peritoneal metastases and therefore this situation was distinguished as the stage IIIA1. Two subgroups were created on the basis of the morphology of lymph node metastases. Microscopic peritoneal metastasis outside the pelvis were staged as IIIA2. The new classification of stage IV was divided into two subgroups; IVA is defined as the presence of histologically or cytologically proven pleural involvment and IVB includs metastases to spleen or liver parenchyma as well as metastases outside the abdominal cavity.

Abstract

Goals of each cancer staging system are similar: it should give evidence about the prognosis of the patient, assist the clinician to plan appropriate treatment, allow for evaluation and comparison of treatment results in different centers and finally contribute to a deeper recognition of malignancy nature. The classification system should also meet three criteria: it should be credible, evidence-based and applicable in clinical practice. During recent years paramount changes have occurred in the pathogenesis of ovarian cancer and recent clinical studies have identified new prognostic factors. Therefore the last change in the classification of ovarian tumors in women was made at the beginning of 2014 and for the first time there were also included fallopian tube and primary peritoneal cancers. The main changes in the updated classification of cancer of the ovary, fallopian tube and the peritoneum are based on dividing the stage IC into three groups including surgical damage to the capsule of the tumor, tumor capsule rupture before the operation and the presence of malignant cells in the peritoneal fluid. Stage IIC has been omit ted. It was also considered that the presence of metastases limited to lymph nodes is a factor of better prognosis than peritoneal metastases and therefore this situation was distinguished as the stage IIIA1. Two subgroups were created on the basis of the morphology of lymph node metastases. Microscopic peritoneal metastasis outside the pelvis were staged as IIIA2. The new classification of stage IV was divided into two subgroups; IVA is defined as the presence of histologically or cytologically proven pleural involvment and IVB includs metastases to spleen or liver parenchyma as well as metastases outside the abdominal cavity.

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Keywords

ovarian neoplasms, fallopian tube neoplasms, peritoneal neoplasms, neoplasm staging

About this article
Title

The new FIGO staging system for ovarian, fallopian tube and primary peritoneal cancer — 2014 update

Journal

Oncology in Clinical Practice

Issue

Vol 11, No 3 (2015)

Article type

Review paper

Pages

129-134

Published online

2015-07-29

Bibliographic record

Onkol. Prak. Klin 2015;11(3):129-134.

Keywords

ovarian neoplasms
fallopian tube neoplasms
peritoneal neoplasms
neoplasm staging

Authors

Kamil Zalewski
Marcin Misiek
Stanisław Góźdź
Mariusz Bidziński

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