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International Federation of Gynecology and Obstetrics Staging Classification for Cancer of the Ovary, Fallopian Tube, and Peritoneum: Estimation of Survival in Patients With Node-Positive Epithelial Ovarian Cancer
  1. Augusto Pereira, MD*,
  2. Tirso Pérez-Medina, MD,
  3. Javier F. Magrina, MD,
  4. Paul M. Magtibay, MD,
  5. Ana Rodríguez-Tapia, MS§,
  6. Irene Peregrin, MD,
  7. Elsa Mendizabal, MD* and
  8. Luís Ortiz-Quintana, MD*
  1. * From the Department of Gynecologic Surgery, Gregorio Marañón University General Hospital; and
  2. Department of Gynecologic Surgery, Puerta de Hierro University Hospital, Madrid, Spain;
  3. Division of Gynecologic Surgery Mayo Clinic Arizona, Scottsdale, AZ; and
  4. §Department of Gynecology and Obstetrics, College of Medicine, Autonoma University, Madrid, Spain.
  1. Address correspondence and reprint requests to Augusto Pereira, MD, Department of Gynecologic Surgery, Gregorio Marañón University General Hospital, C/ Maiquez, 7 Madrid 28009, Spain. E-mail: apereiras{at}


Objective The objective of this study was to determine the survival of patients with node-positive epithelial ovarian cancer according to the 2014 International Federation of Gynecology and Obstetrics (FIGO) staging system.

Materials and Methods We performed a retrospective chart review. Data from all consecutive patients with node-positive epithelial ovarian cancer (stages IIIC and IV) who underwent cytoreductive surgery at the Mayo Clinic from 1996 to 2000 were reassessed to evaluate the prognostic significance of the new FIGO stages. Multivariate Cox regression was performed, and Kaplan-Meier survival curves constructed.

Results The distribution of the restaged patients was as follows: IIIA1, 23 patients (IIIA1i, 9 patients; and IIIA1ii, 14 patients); IIIA2, 3 patients; IIIB, 4; IIIC, 67 patients; IVA, 4 patients; and IVB, 15 patients. In the univariate analysis, the relative risk for positive nodes greater than 10 mm on the longer axis was 2.57 and 3.00 for patients with microscopic peritoneal disease, compared with patients with microscopic positive nodes. However, the difference was not statistically significant. Moreover, the univariate analyses revealed statistically significant differences for 2014 FIGO stages (IIIA, IIIB, IIIC, and IVA-B), anatomical sites of peritoneal metastases, and disease staged at IIIC because of the presence of omental metastases. Multivariate analysis showed that survival was higher in patients restaged to IIIA-B than in those restaged to IIIC and IV (hazard ratios, 2.75 and 3.16, respectively; P = 0.002). The hazard ratio for patients with abdominal peritoneal metastases was 2.76 compared with patients with pelvic peritoneal metastases (P = 0.001).

Conclusions The current 2014 FIGO staging system for ovarian cancer successfully correlates survival, anatomical location of peritoneal metastases, and extra-abdominal lymph node metastases.

  • Ovarian cancer
  • 5-Year overall survival
  • FIGO staging classification

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  • The authors declare no conflicts of interest. No funding was received for this work.