Yonsei Med J.  2014 May;55(3):563-569. 10.3349/ymj.2014.55.3.563.

FIGO Staging for Uterine Sarcomas: Can the Revised 2008 Staging System Predict Survival Outcome Better?

• Yim GW
• Nam EJ
• Kim SW
• Kim YT

• KMID: 2068663
• DOI: http://doi.org/10.3349/ymj.2014.55.3.563

Abstract

PURPOSE
The aim of this study was to compare survival of patients with uterine sarcomas using the 1988 and 2008 International Federation of Gynecologists and Obstetricians (FIGO) staging systems to determine if revised 2008 staging accurately predicts patient survival.
MATERIALS AND METHODS
A total of 83 patients with leiomyosarcoma and endometrial stromal sarcoma treated at Yonsei University Health System between March of 1989 and November of 2009 were reviewed. The prognostic validity of both FIGO staging systems, as well as other factors was analyzed.
RESULTS
Leiomyosarcoma and endometrial stromal sarcoma comprised 47.0% and 53.0% of this study population, respectively. Using the new staging system, 43 (67.2%) of 64 eligible patients were reclassified. Among those 64 patients, 45 (70.3%) patients with limited uterine corpus involvement were divided into stage IA (n=14) and IB (n=31). Univariate analysis demonstrated a significant difference between stages I and II and the other stages in both staging systems (p<0.001) with respect to progression-free survival and overall survival (OS). Age, menopausal status, tumor size, and cell type were significantly associated with OS (p=0.011, p=0.031, p=0.044, p=0.009, respectively). In multivariate analysis, revised FIGO stage greater than III was an independent poor prognostic factor with a hazard ratio of 9.06 [95% confidence interval (CI) 2.49-33.0, p=0.001].
CONCLUSION
The 2008 FIGO staging system is more valid than the previous FIGO staging system for uterine sarcomas with respect to its ability to distinguish early-stage patients from advanced-stage patients.

Keyword

Uterine sarcoma; FIGO staging; prognosis

MeSH Terms

Adult
Disease-Free Survival
Female
Humans
Leiomyosarcoma/mortality/pathology
Male
Middle Aged
Neoplasm Staging
Prognosis
Uterine Neoplasms/*mortality/*pathology

Figure

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  Fig. 1 Survival curves for patients with stage I disease according to the 1988 FIGO staging system (A) and 2008 FIGO staging system (B).

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  Fig. 2 Survival curves by stage.

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  Fig. 3 Survival curves by the tumor size and depth of myometrial invasion.

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