Validation of the 2018 FIGO Staging System of Cervical Cancer for Stage III Patients with a Cohort from China

Abstract

Xiaoliang Liu,1,* Junjie Wang,2,* Ke Hu,1 Fuquan Zhang,1 Qingyu Meng,1 Weiping Wang,1 Dunhuang Wang,1,3 Ziqi Zhou,1 Kang Ren1 1Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Gynecological Oncology, Qingdao Center Hospital, Qingdao, Shandong, People’s Republic of China; 3Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ke Hu; Fuquan ZhangDepartment of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing 100730, People’s Republic of ChinaTel [phone]; [phone]Fax [phone]Email [email protected]; [email protected]: To validate the 2018 revised FIGO cervical cancer staging system for stage III patients with a cohort from China.Patients and Methods: Patients with stage III cervical cancer (FIGO 2018) treated with definitive radiotherapy at our institute were reviewed. Each patient was evaluated with both the 2014 and 2018 staging systems. Disease-free survival (DFS) was calculated with the Kaplan-Meier method. Receiver operative characteristic (ROC) curves for the predictive accuracy of DFS in patients with cervical cancer according to different FIGO staging systems were created.Results: Between January 2008 and December 2014, a total of 586 patients with FIGO stage IIIC cervical cancer (2018) were treated with definitive radiotherapy at our institute. The 3-year DFS for patients according to FIGO stage (2014) were as follows: IB2 73.2%, IIA 63.7%, IIB 66.7%, IIIA 64.7%, and IIIB 59.6% (P=0.580). The 3-year DFS according to FIGO stage (2018) were IIIA 79.9%, IIIB 70.4%, IIIC1 66.3% and IIIC2 29.8% (P< 0.001). The AUC values for DFS were 0.552 (95% CI: 0.503– 0.600, P=0.037) and 0.623 (95% CI: 0.575– 0.671, P< 0.001) for the 2014 and 2018 FIGO staging systems, respectively.Conclusion: The 2018 FIGO staging system of cervical cancer showed more distinction within stages and better predictive accuracy for DFS than the preceding staging system in patients with stage III disease from China.Keywords: cervical cancer, FIGO 2018 staging system, validation, China

Keywords

• cervical cancer
• figo 2018 staging system
• validation
• china