The document outlines the FIGO staging systems for ovarian cancer, endometrial cancer, and cervical cancer. It describes the stages from I to IV, defining the extent of primary tumor and metastasis involvement for each type of cancer. It then focuses on cervical cancer, discussing the TNM classification system and how it can guide therapy depending on whether the cancer is non-bulky or bulky. Treatment options including surgery, radiation, chemotherapy, and chemoradiation are covered.

2. Ovarian cancer / Fallopian tube / Peritoneal
carcinomatosis
Stage I
One or both
ovaries (or
fallopian tube)
involvement
Stage II
Whole tumor
burden below
pelvic brim
-
Primary
peritoneal
carcinoma
Stage III
Peritoneal
involvement
outside the
pelvis
-
Retroperitoneal
lymph-nodes
Stage IV
Extra-
abdominal
involvement
-
Liver, spleen,
transmural
bowel, etc
Simplified FIGO staging system for Ovarian Cancer

3. Endometrial cancer
Stage I
Confined to the
corpus uteri
(including
endocervical
glandular
component)
Stage II
Tumor involves
stroma
component of
the uterine
cervix (no tumor
beyond the
uterus)
Stage III
Tumor invades
the serosa,
adventitia,
vagina or
parametrium
Stage IVa
Tumor invading
the bladder
mucosa or the
rectal mucosa
Simplified FIGO staging system for Endometrial Cancer
Stage IVb
Distant
metastasis

4. Cervical cancer
Stage I
Confined to the
uterus
Stage II
Beyond the
uterus but not
to the pelvic
wall or lower
third of the
vagina
Stage III
Extension to the
pelvic wall, or
lower third of
the vagina, or
causing
hydronephrosis
(or non-
functioning
kidney)
Stage IVa
Tumor invading
the bladder
mucosa or the
rectal mucosa,
or extension
beyond the true
pelvis
Simplified FIGO staging system for Cervical Cancer
Stage IVb
Distant
metastasis

6. - histology:

7. NEW TNM proposal for cervical cancer

8. TNM
N0
N1:
Regional LNs
T1: cervix, only
T2: a little
Outside the
cervix
T3: pelvic wall
Or most vagina
M0: No distant
metastasis
M1: Distant
metastasis
T4: Other organs by
contiguity
LN: Lymph nodes
Enough tnm to guide
therapy for cervical cancer

9. Stage distribution USA
SEER, Accessed, 2019

10. GYN oncologist

11. TNM
T1: cervix, only
T2: a little
Outside the
cervix
Enough tnm to guide
therapy for cervical cancer
Non-bulky
IA1, IA2, Ib1, IIA1
Less than 4 cm
Bulky
IB2, IIA2, IIB…

12. Types of radical histerectomy

13. Pareja knows his stuff

14. TNM
Enough tnm to guide
therapy for cervical cancer
Non-bulky
IA1, IA2, Ib1, IIA1
Less than 4 cm
Surgery
(preferred)
Ie, Open radical Histerectomy
and pelvic lymphadenectomýy
RT or CHEMO RT
If surgery not an option
Less invasive surgery an
option for some patients
with very eraly disease for
fertility preservation

15. Lungs
REGIONAL involvement.
soft-tissues
Lymph-nodes
Bladder
rectum

16. Whole body
cXR
Chest ct

17. TNM
Enough tnm to guide
therapy for cervical cancer
Bulky IB2, IIA2,
Stage III, IVA
Definitive
Chemo-rt
Cisplatin-based

18. Cisplatino: 40 mg/m2/cada semana por 6 (Junto con teleterapia)
Teleterapia (EBR) – Lunes a viernes, por 6-7 semanas - 4000-5000 cGY
Braquiterapia (4000 -5000 cGy)
1 7 14 21 28 35 (Días)

19. Thomas, G. M. (1999). Improved Treatment for Cervical Cancer ? Concurrent Chemotherapy and Radiotherapy. New
England Journal of Medicine, 340(15), 1198–1200. https://doi.org/10.1056/NEJM199904153401509

21. “sorpresas te de la vida”
Ruben blades

23. FIGO CANCER REPORT 2018 (Bhatla N. Int J Gynecol Obstetrics 2018; 143 (Suppl.
Cervical cancer

24. TNM
Enough tnm to guide
therapy for cervical cancer
Stage IV-B
Palliative
chemotherapy
Cisplatin-based

25. Cisplatin + Paclitaxel +/- Bevacizumab

26. Thomas, G. M. (1999). Improved Treatment for Cervical Cancer ? Concurrent Chemotherapy and Radiotherapy. New
England Journal of Medicine, 340(15), 1198–1200. https://doi.org/10.1056/NEJM199904153401509

27. Thomas, G. M. (1999). Improved Treatment for Cervical Cancer ? Concurrent Chemotherapy and Radiotherapy. New
England Journal of Medicine, 340(15), 1198–1200. https://doi.org/10.1056/NEJM199904153401509