子宫内膜癌与新的FIGO分期课件.pptVIP

Endometrial Cancer and Updates of FIGO Staging子宫内膜癌与新的FIGO分期 Wenxin Zheng, M.D. Professor of Pathology Professor of Obstetrics and Gynecology Director of Gynecologic Pathology and Molecular Pathology University of Arizona College of Medicine zhengw@ /index.html Beijing, May 2009 Corpus Cancer Staging (FIGO 1971) Stage Characteristics 0 Carcinoma in situ I The carcinoma is confined to the corpus IA The length of the uterine cavity is 8 cm or less IB The length of the uterine cavity is 8 cm Stage I cases should be subgrouped with regard to the histologic grade of the adenocarcinoma II The carcinoma has involved the corpus and the cervix III The carcinoma has extended outside of the uterus but not outside of the true pelvis IV The carcinoma has extended outside of the true pelvis or has involved the mucosa of the bladder or rectum Corpus Cancer Staging (FIGO 1988) Stage Characteristics IA G123 Tumor limited to endometrium IB G123 Invasion to 1/2 myometrium IC G123 Invasion to 1/2 myometrium IIA Endocervical glandular involvement only IIB Cervical stromal invasion IIIA Tumor invades serosa and/or adnexae and/or positive peritoneal cytology IIIB Vaginal involvement or metastasis IIIC Metastasis to pelvic and/or para-aortic lymph nodes IVA Tumor invasion of bladder and/or bowel mucosa IVB Distant metastasis including intra-abdominal and/or inguinal lymph nodes 5-Year Survival Differences Significance of this change Changed from clinical based classification to a surgico-pathologic system Represented a dramatic improvement From inaccurate to more predictive and better reproducible Represented a significant advance in prognosis and therapy selection Emphasized the importance of pathology evaluation Pathologic classification of endometrial adenocarcinomas 1980 2005 Adenocarcinoma Endometrioid Adenoacanthoma Endometrioid with squamous diff Adenosquamous V