title: Uterine leiomyosarcoma in asian patients: validation of the revised Federation of gynecology and obstetrics staging system and identification of prognostic classifiers.
abstract: BACKGROUND
  In 2008, the Federation of Gynecology and Obstetrics (FIGO) revised their 1988 staging system for uterine leiomyosarcomas. In this article, we compare performance of the 2008 and 1988 FIGO systems.
  
  
  METHODS
  Individual case data were manually culled. Staging was retrospectively assessed according to revised and 1998 FIGO criteria. Overall survival distribution was assessed by the Kaplan-Meier method. Harrell's concordance index was used to assess the discriminative ability of a fitted Cox model to predict overall survival.
  
  
  RESULTS
  A total of 110 cases of uterine leiomyosarcomas were reviewed and data from 88 patients were analyzed. In all, 71% of cases were classified as stage I, 7% as stage II, 3% as stage III, and 19% as stage IV under the revised FIGO staging system. Nine patients (10.2%) were downstaged and none were upstaged. The revised FIGO system did not show a significant improvement over the 1988 FIGO system in the ability to discriminate the risk of death of patients between stages, with concordance indexes of 0.70 and 0.71, respectively. Most patients were classified as stage I with age, tumor grade, tumor size, and lymphovascular invasion as prognostic factors.
  
  
  CONCLUSIONS
  The 2008 revised FIGO staging system for uterine leiomyosarcomas does not perform better than the 1988 system for uterine endometrial carcinomas. A better staging system is needed for these cases.
authors: Department of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Republic of Singapore.
authors: Pei-Shan
authors: PS
authors: Tan
authors: Elisa
authors: E
authors: Koh
authors: Cindy
authors: C
authors: Pang
authors: Whee-Sze
authors: WS
authors: Ong
authors: Lynette
authors: L
authors: Ngo
authors: Lay-Tin
authors: LT
authors: Soh
authors: Richard
authors: R
authors: Quek
authors: Wen-Yee
authors: WY
authors: Chay
authors: Tew-Hong
authors: TH
authors: Ho
authors: Sun-Kuie
authors: SK
authors: Tay
authors: Sung-Hock
authors: SH
authors: Chew
authors: Soo-Kim
authors: SK
authors: Lim-Tan
authors: Hs
authors: H
authors: Khoo-Tan
authors: Sheow Lei
authors: SL
authors: Lim
authors: Inny
authors: I
authors: Busmanis
authors: Liang Kee
authors: LK
authors: Goh
authors: Yin-Nin
authors: YN
authors: Chia
authors: Whay-Kuang
authors: WK
authors: Chia
authors: Timothy
authors: T
authors: Lim
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000473:pathology*