TAILIEUCHUNG - FIGO Staging of Endometrial Adenocarcinoma: A Critical Review and Proposal

Gilda Restelli was nearly 30 weeks pregnant when doctors discovered that her fetus had only fragments of a skull and almost no brain. Medical experts told Gilda and her husband that their baby had almost no chance of survival after birth. She quit her job, not because she was physically incapacitated, but because she could no longer bear the hearty congratulations of strangers who were unaware of the tragic circumstances surrounding her pregnancy. The Restellis made the agonizing decision to end the pregnancy, and even though state law included a health exception, the couple had to battle. | International Journal of Gynecological Pathology 28 1-9 Lippincott Williams Wilkins Baltimore 2008 International Society of Gynecological Pathologists Review Article FIGO Staging of Endometrial Adenocarcinoma A Critical Review and Proposal Richard J. Zaino . Summary The optimal staging of tumors would reflect their biology and patterns of spread permit accurate prognostication and facilitate therapeutic decision-making. The last revision of the International Federation of Obstetricians and Gynecologists FIGO staging of uterine corpus tumors was in 1988 and it represented the transition from a clinical to a surgico-pathologic system. With 20 years of experience we can now review the accuracy reproducibility and utility of this system. Pathologists are in a unique position to study each of these characteristics comment on their ability to apply the criteria in daily practice and offer suggestions to further improve the FIGO system. This paper selectively reviews some of the more problematic aspects of the current FIGO system including the following the distinction of tumors confined to the endometrium from those which are superficially myoinvasive the method and utility of histologic grading of endometrial adenocarcinoma the utility and reproducibility of the diagnosis of cervical epithelial and stromal invasion the striking heterogeneity within and among stage III A B and C tumors and their differing prognostic significance. It concludes with recommendations for changes in a future revision of the FIGO staging of endometrial carcinoma. Key Words Endometrium Carcinoma FIGO Stage. In 1988 the International Federation of Obstetricians and Gynecologists FIGO made significant changes to the staging scheme for cancers of the uterine corpus 1 replacing the clinically based 1970 classification 2 3 with a surgico-pathologic system Tables 1 2 . This occurred in part because of a change during the previous decade in the clinical management of endometrial carcinoma with .

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