Does "One Size Fits All"? Rethinking FIGO Depth of Invasion Measurements in Vulvar Cancer.
Journal
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists
ISSN: 1538-7151
Titre abrégé: Int J Gynecol Pathol
Pays: United States
ID NLM: 8214845
Informations de publication
Date de publication:
02 Feb 2024
02 Feb 2024
Historique:
medline:
2
2
2024
pubmed:
2
2
2024
entrez:
2
2
2024
Statut:
aheadofprint
Résumé
Depth of invasion (DOI) is an important diagnostic parameter in patients with vulvar carcinoma, where a cutoff value of 1 mm largely determines the tumor stage and the need for groin surgery. DOI measurement should be reproducible and straightforward. In light of the new recommendation on how to measure DOI in the International Federation of Gynecology and Obstetrics (FIGO) staging system 2021, an exploratory study was conducted on the current practice of DOI measurement in vulvar cancer. In this study of 26 selected cases, 10 pathologists with high exposure to vulvar cancer cases in daily practice assessed both the conventional (FIGO 2009) and alternative (FIGO 2021) DOI methods for applicability and preference. In this set of cases, the DOI measurement according to FIGO 2009 was generally considered easier to apply than the measurement according to FIGO 2021, with applicability being rated as "easy to reasonable" in 76.9% versus 38.5% of cases, respectively (P=0.005). The preferred method was FIGO 2009 or tumor thickness in 14 cases and FIGO 2021 in 6 cases. No invasion was preferred in 1 case. For the remaining 5 cases, half of the pathologists opted for the FIGO 2009 method and half for the FIGO 2021 method. Although the FIGO 2009 method proved to be more readily applicable in most of the cases studied, the method may differ for each case. There may not be a "one size fits all" solution for all cases of vulvar cancer.
Identifiants
pubmed: 38303108
doi: 10.1097/PGP.0000000000001009
pii: 00004347-990000000-00138
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 by the International Society of Gynecological Pathologists.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
Références
Hacker NF. Revised FIGO staging for carcinoma of the vulva. Int J Gynaecol Obstet 2009;105:105–6.
Olawaiye AB, Cotler J, Cuello MA, et al. FIGO staging for carcinoma of the vulva: 2021 revision. Int J Gynaecol Obstet 2021;155:43–7.
Magrina JF, Gonzalez-Bosquet J, Weaver AL, et al. Squamous cell carcinoma of the vulva stage IA: long-term results. Gynecol Oncol 2000;76:24–7.
Yoder BJ, Rufforny I, Massoll NA, et al. Stage IA vulvar squamous cell carcinoma: an analysis of tumor invasive characteristics and risk. Am J Surg Pathol 2008;32:765–72.
Wilkinson EJ. Superficially invasive carcinoma of the vulva. Clin Obstet Gynecol 1991;34:651–61.
Wilkinson EJ. Superficial invasive carcinoma of the vulva. Clin Obstet Gynecol 1985;28:188–95.
van den Einden LC, Massuger LF, Jonkman JK, et al. An alternative way to measure the depth of invasion of vulvar squamous cell carcinoma in relation to prognosis. Mod Pathol 2015;28:295–302.
Skala SL, Ebott JA, Zhao L, et al. Predictive value of an alternative strategy for measuring depth and size of stage 1 vulvar squamous cell carcinoma. J Low Genit Tract Dis 2020;24:265–71.
Pouwer AW, Bult P, Otte I, et al. Measuring the depth of invasion in vulvar squamous cell carcinoma: interobserver agreement and pitfalls. Histopathology 2019;75:413–20.
Oonk MHM, Planchamp F, Baldwin P, et al. European Society of Gynaecological Oncology Guidelines for the management of patients with vulvar cancer—update 2023. Int J Gynecol Cancer 2023;33:1023–43.