GONC Flashcards
What is the FIGO 2018 staging of cervical cancer?
Stage 1A1 - Invasive carcinoma only by microscopy with DOI < 3mm.
Stage 1A2 - “ “ with DOA < 5mm.
Stage 1B1 - Lesion limited to cervix with DOI ≥ 5mm and < 2cm in greatest dimension.
Stage 1B2 - Lesion limited to cervix with invasive carcinoma ≥ 2cm and < 4cm in maximum dimension.
Stage 1B3 - Lesion limited to cervix ≥ 4cm in maximum dimension.
Stage 2 - Extends to uterus but not onto lower third of vagina or pelvic wall.
Stage 2A1 - Invasive carcinoma < 4cm in greatest dimension.
Stage 2A2 - Invasive carcinoma with greatest dimension ≥ 4cm.
Stage 2B - Parametrial involvement but not up to pelvic wall.
Stage 3 - Involves lower third of vagina and/or extends to the pelvic wall and/or causes hydronephrosis or nonfunctioning kidney.
Stage 3A - Lower third of vagina involved but no extension to pelvic wall.
Stage 3B - Extension to pelvic wall and/or hydronephrosis or non-functioning kidney.
Stage 3C1 - Pelvic lymph node involvement.
Stage 3C2 - Para-aortic lymph node involvement.
Stage 4A - Spread to adjacent pelvic organs.
Stage 4B - Spread to distant organs.
What is the FIGO 2009 staging of vulval cancer?
Stage 1 - Tumors confined to the vulva.
1A - Lesion ≤ 2cm in size and DOI ≤ 1mm, no nodal metastasis.
1B - Lesion > 2cm in size and DOI > 1mm, no nodal metastasis.
Stage 2 - Tumor extends to adjacent perineal structures - Lower 1/3rd of urethra, lower 1/3rd of vagina, anus, negative nodes.
Stage 3 - Tumor of any size without extension to adjacent perineal structures with positive inguino-femoral nodes
3A - 1 lymph node metastasis.
3B - 2 or more lymph node metastasis.
3C - postive nodes with extracapsular spread.
Stage 4 - Tumor invades other regional or distant structures - 2/3rd of upper urethra, 2/3rd of upper vagina, or distant structures.
4A - Tumor invades upper urethral or vaginal mucosa, bladder mucosa, rectal mucosa, or fixed to pelvic bone. Also if fixed or ulcerated inguino-femoral nodes.
4B - Any distant metastasis including pelvic lymph nodes.
What is Sidlis criteria for adjuvant treatment in cervical cancer (intermediate risk factors)?
If 2/3 criteria of:
1. Large tumor size > 4cm.
2. > 1/3rd stromal invasion.
3. LVSI
then give radiotherapy which improves PFS but not OS.
What is Peters criteria in cervical cancer (high risk factors)?
If 1/3 criteria of:
1. Positive of close margin.
2. Parametrial invasion.
3. Positive lymph node.
there is a 40% risk of recurrence therefore chemoradiotherapy advised to improve both PFS and OS.
