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Clinical and imaging findings in cervical cancer and their impact on FIGO and TNM staging - An analysis from the EMBRACE study.

Abstract：

OBJECTIVE:To investigate differences in local tumour staging between clinical examination and MRI and differences between FIGO 2009, FIGO 2018 and TNM in patients with primary cervical cancer undergoing definitive radio-chemotherapy. METHODS:Patients from the prospective observational multi-centre study "EMBRACE" were considered for analysis. All patients had gynaecological examination and pelvic MRI before treatment. Nodal status was assessed by MRI, CT, PET-CT or lymphadenectomy. For this analysis, patients were restaged according to the FIGO 2009, FIGO 2018 and TNM staging system. The local tumour stage was evaluated for MRI and clinical examination separately. Descriptive statistics were used to compare local tumour stages and different staging systems. RESULTS:Data was available from 1338 patients. For local tumour staging, differences between MRI and clinical examination were found in 364 patients (27.2%). Affected lymph nodes were detected in 52%. The two most frequent stages with FIGO 2009 are IIB (54%) and IIIB (16%), with FIGO 2018 IIIC1 (43%) and IIB (27%) and with TNM T2b N0 M0 (27%) and T2b N1 M0 (23%) in this cohort. CONCLUSIONS:MRI and clinical examination resulted in a different local tumour staging in approximately one quarter of patients. Comprehensive knowledge of the differential value of clinical examination and MRI is necessary to define one final local stage, especially when a decision about treatment options is to be taken. The use of FIGO 2009, FIGO 2018 and TNM staging system leads to differences in stage distributions complicating comparability of treatment results. TNM provides the most differentiated stage allocation.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Knoth J,Pötter R,Jürgenliemk-Schulz IM,Haie-Meder C,Fokdal L,Sturdza A,Hoskin P,Mahantshetty U,Segedin B,Bruheim K,Wiebe E,Rai B,Cooper R,van der Steen-Banasik E,van Limbergen E,Pieters BR,Sundset M,Tan LT,Nout RA,T

doi

10.1016/j.ygyno.2020.07.007

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

136-141

issue

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(20)32382-9

journal_volume

159

pub_type

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Clinical and imaging findings in cervical cancer and their impact on FIGO and TNM staging - An analysis from the EMBRACE study.