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1971년 1월 1일 이후부터 시행되는 여성성기암의 분류

Classification and staging of malignant tumours in the female pelvis (To be used from Jan.], 197;1)

대한산부인과학회지 1970년 13권 11호 p.31 ~ 42
大韓産婦人科學會

Abstract


The classification and staging of tumours in the female pelvis are considered not only by the Cancer Committee of the International Federation of Gynecology and Obstetrics, but also by the International Union Against Cancer, especially its TNM Committee, by the Cancer Unit of the W.H.O., by the Reference Centers of the,W. H.O. for histopathological classification of ovarian tumors as well as of tumors in the uterus and the vagina, by the American Joint Committee, and finally, by the International Congress of Radiology, especially its committee I.C.P.R. For severall years opinions differed concerning the classification and staging of malignant tumours in the female pelvis. The Cancer Committee of F.I.G.O. has aimed at adjusting these opinions. It has been possible to reach international agreement on several main issues which are considered to be of great importance for research.
The TNM classification makes it possible to describe in detail the anatomical extent of the disease. If, however, used as the only method of classification it will divide a series of treated cases into so many small groups that a statistical evaluation of the material is not possible. The Cancer Committee of F.I.G.O. stresses the importance of staging, and experience has shown that from a statistical as well as from a prognostic point of view it is advisable to group every type of malignant tumour into four stages.
Although the U. I.C.C. adheres to the TNM classification we wish to point out that there is, in principle, no important difference between the classification and staging adopted by the U.I.C.C. and the one adopted by F.I.G.O. as far as carcinoma of the cervix uteri, carcinoma of the corpus uteri, and carcinoma of the vagina are concerned.
The F. I. G. O. clinical stage-grouping of carcinoma of the uterus and carcinoma of the vagina had already existed for many years when the proposals by the U.I.C.C. were presented. Experience has shown that institutions in all countries of the world are using the F. I. G. O. clinical stage-grouping. The collaboration. between the U.I. C. C.
and the Cancer Committee of F.I. G. O. is very important and it is of value that the so called TNM classification of carcinoma of the uterus and carcinoma of the vagina follow the same lines as the clinical stage-grouping adopted by F.I.G.O. In this respect, however, we have to remember that the stage-grouping is based exclusively on clinical (i) capsule ruptured, (ii) capsule not ruptured.
Stage Ic Growth limited to one or both ovaries; ascites present with malignant cells in the fluid
(i) capsule ruptured, (ii) capsule not ruptured.
Stage !t Growth involving one or both ovaries with pelvic extension.
Stage Ha Extension and/or metastases to the uterus and/or tubes and/or other ovary.
Stage IIb Extension to other pelvic tissues.
Stage HI Growth involving one or both ovaries with wide-spread intraperitoneal metastases.
Stage IV Growth involving one or both ovaries with distant metastases. Special category : Unexplored cases which are thought to be ovarian carcinoma.

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