Is the International Federation of Gynecology and Obstetrics staging system for cervical carcinoma able to predict survival in patients with cervicalcarcinoma? An assessment of clinimetric properties

BACKGROUND. The objective of this article was to assess the clinimetric pro perties of the International Federation of Gynecology and Obstetrics (FIGO) staging system of cervical carcinoma to determine whether it is an adequat e prognostic tool for the survival of patients with cervical carcinoma. METHODS. The FIGO staging system for cervical carcinoma was evaluated with regard to item generation, item reduction, sensibility, reliability, and va lidity. RESULTS. Many statistically significant and clinically important variables have been omitted from the current staging system for cervical carcinoma. T he item-reduction step for the formulation of the prognostic tool has not b een described by the authors of the FIGO staging system, but a consensus pr ocess is assumed. There are no studies currently available to assess the re liability of interobserver and intraobserver variability in applying the st aging system to patients with cervical carcinoma. A trial to assess the rel iability of this tool is proposed by the authors. Although there are no pro spective trials to assess the criterion validity of the FIGO staging system , there is enough literature to suggest that the staging system is not capa ble of discriminating with regard to patient survival within and between st ages. CONCLUSIONS. The current FIGO staging system for cervical carcinoma does no t fully meet the majority of methodologic criteria for a strong predictive tool. Developing an improved prognostic index containing a complete array o f independently prognostic variables is suggested. (C) 2001 American Cancer Society.