Hn. Nguyen et al., NATIONAL SURVEY OF OVARIAN CARCINOMA-VI - CRITICAL-ASSESSMENT OF CURRENT INTERNATIONAL FEDERATION OF GYNECOLOGY AND OBSTETRICS STAGING SYSTEM, Cancer, 72(10), 1993, pp. 3007-3011
Background. The Commission on Cancer of the American College of Surgeo
ns recently completed a national survey of patients with ovarian cance
r. From the large database, the prognostic value of current Internatio
nal Federation of Gynecology and Obstetrics (FIGO) staging system for
ovarian carcinoma was re-examined. Methods. Data was collected from 25
consecutive ovarian carcinomas diagnosed in 1983 and 1988 at 904 hosp
itals with cancer programs. Among a total of 12,316 cases, 5156 patien
ts had long-term survival data. Results. The overall 5-year survivals
were 88.9 +/- 0.9%; 57.1 +/- 2.4%; 23.8 +/- 1.3%; and 11.6 +/- 0.9% fo
r Stages I, II, III, and IV, respectively. Pairwise survival compariso
ns using Lee-Desu statistic confirmed the prognostic value of current
staging system (P < 0.00001). When survival data was substratified fur
ther to substage division, the 5-year survivals were: IA, 92.1 +/- 0.9
%; IB, 84.9 +/- 3.4%; IC, 82.4 +/- 2.0%; IIA, 69.0 +/- 4.3%; IIB, 56.4
+/- 3.6%; IIC, 51.4 +/- 4.5%; IIIA, 39.3 +/- 2.8%; IIIB, 25.5 +/- 2.6
%; IIIC, 17.1 +/- 1.4%; and IV, 11.6 +/- 0.9%. As the disease process
becomes more advanced, patients' survival reduces proportionally. Howe
ver, the survival reduction is relatively small between IB-IC and IIB-
IIC divisions. Survival comparisons revealed significant prognostic va
lue for most substage divisions (P = 0.03-0.0002) except for IB-IC and
IIB-IIC combinations (P > 0.33). Further analyses revealed no signifi
cant differences between IB-IC and IIB-IIC patients in several prognos
tic parameters such as age, histologic grade, cell type, and amount of
residual disease. Conclusions. These data support the current FIGO st
aging system. However, Substages IB-IC and IIB-IIC should be combined
to respective single substages.