Controversies in Gynecologic Cancer Staging: An AJCC Cancer Staging Manual, Eighth Edition Perspective

Staging systems provide a common language to support clinical research and decision making in patients with cancer. The eighth edition of the AJCC Cancer Staging Manual incorporates updates that reflect evolving clinical practices and scientific insights. The present article summarizes changes that have been made for gynecologic subsites and outlines continued challenges. Gynecologic American Joint Committee on Cancer/International Union Against Cancer staging continues to conform closely to current International Federation of Obstetrics and Gynecology staging. The eighth edition is aligned with the major revision made to International Federation of Obstetrics and Gynecology staging of ovarian cancer in 2014 and contains a unified staging system for ovarian, fallopian tube, and primary peritoneal cancer. Continuing challenges for ovarian cancer include determining the relative significance of intraoperative rupture, surface involvement, and positive washings, which are rank ordered in the new staging system. Another challenge is assignment of a tubal versus ovarian primary site for high-grade serous carcinoma, which cannot be done in a reliable way. In uterine carcinoma, endometrial intraepithelial carcinoma is now recognized as a T1 cancer, and nodal micrometastases have been defined with their own N stage. Also, isolated tumor cells in lymph nodes have been incorporated in the staging of all gynecologic carcinomas. The staging of uterine sarcoma is largely unchanged. Future...
Source: Pathology Case Reviews - Category: Pathology Tags: Reviews Source Type: research