title: Old versus new FIGO staging systems in predicting overall survival in patients with uterine leiomyosarcoma: a study of 86 cases.
abstract: OBJECTIVE
  Uterine leiomyosarcoma (uLMS) was staged using the FIGO system for endometrial cancers. The new FIGO system takes into consideration tumor size disregarding myometrial and cervical involvement. We aimed to compare the two systems and see which more accurately predicts overall survival (OS).
  
  
  METHODS
  86 patients with uLMS (1984-2010) were retrospectively staged using both FIGO systems. Mean OS rates were estimated using the Kaplan-Meier method.
  
  
  RESULTS
  More patients had stage-I disease by the new FIGO system (42 versus 33). Five versus 18 and 27 versus 5 had old and new stage-II and III diseases respectively. Five and 4 patients with old stage II and III uLMS respectively were downstaged to stage I while 18 with old stage III were downstaged to stage II. Median follow-up was 23.5 months with a median OS of 114 (95% CI, 61-166) months. Although patients with stage I tumors had a higher mean OS rate compared to those with higher stage disease by either system, patients with old stage II-IV disease showed similar mean OS rates, with stage III-IV patients having a slightly better mean OS and a similar trend was observed with the new system. Patients with new FIGO stage III had a higher mean OS rate than those with stage II or IV disease (37.6 versus 28.1 and 34.3 months). Nonetheless, no statistical significant differences were seen in OS according to stage using either system (p=0.786 and p=0.400 respectively).
  
  
  CONCLUSIONS
  Neither FIGO staging system is ideal in classifying patients into four clinically significant stages.
authors.affiliation: Department of Pathology, National University Health System, Singapore.
authors.forename: D
authors.initials: D
authors.lastname: Lim
authors.forename: W L
authors.initials: WL
authors.lastname: Wang
authors.forename: C H
authors.initials: CH
authors.lastname: Lee
authors.forename: T
authors.initials: T
authors.lastname: Dodge
authors.forename: B
authors.initials: B
authors.lastname: Gilks
authors.forename: E
authors.initials: E
authors.lastname: Oliva
mesh_terms: D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014594:Uterine Neoplasms / Q000473:pathology*