Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium.

Thefirst rules for classification and stagingof female genital cancers adopted by the International Federation of Gynecology and Obstetrics (FIGO) in 1958 date back to the end of the 1920s and the work carried out by the Radiological Sub-Commission of the Cancer Commission of the Health Organization of the League of Nations. Since the 1930s, gynecologic oncologists have strived for a common language to facilitate making diagnoses and planning treatment for their patients. The aim was, and still is, to reach a uniform/unified terminology that is able to provide appropriate prognosis to the patients and to enhance the exchange of information among health professionals. FIGOwas thefirst organization to develop its own classification and staging system. Subsequently, in 1966, the International Union Against Cancer (UICC) published its own staging system, followed by the American Joint Commission on Cancer (AJCC) in 1976. Since then, one of the aims of these 3 organizations has been to review any changes to the different staging systems, and to jointly agree upon them. Cancer staging is in constant evolution because it must adapt to significant scientific changes. In the last decades, medical research and practice, particularly in the field of oncology, have shown explosive growth. In the light of these breakthroughs, the scientific community— with the supportof FIGOaswell asother international scientific societies and agencies—felt that the time had come to revise the staging of some of the gynecologic cancers. However, difficulties always arise each time the scientific community puts forward revisions to cancer stagings. In general, these are due to the interpretation of evidence-based data and the impact such data can have on the staging itself. Cancers of the female genital tract are surgically staged, with the exceptions of staging for cervical cancer, which is clinical, and staging for gestational trophoblastic neoplasia (GTN), which combines clinical and biological aspects. Mainly because of epidemiological reasons rather than scientific rationale, cervical cancer is still clinically staged. Over the past 3 years, much time and attention have been devoted to reviewing proposals concerning cancer of the vulva, cervix uteri, and corpus uteri, which were revised in 1988, 1994, and 1988, respectively. Ovarian cancer staging has not been tackled. It is the aim of the FIGO Committee onGynecologicOncology toupdate the stagingof this disease in the next 3 years. The revision process started under the leadership of the former Chairperson of the FIGO Committee onGynecologic Oncology, Professor Hextan Ngan, and has since continued under my chairmanship. Two seminarswere organized.Onewasheldduring the11thBiennial Meeting of the International Gynecologic Cancer Society (IGCS), held from October 14–18, 2006, in Santa Monica, USA; the other was held during the 18th FIGO World Congress, November 5–10, 2006, in Kuala Lumpur, Malaysia. The discussions and debates during the seminars led to some proposed changes that were presented and discussed at the Annual Meeting of the TNM Prognostic Factors Core Group, held