ASSESSING THE IMPACT OF UPDATED 2018 FIGO STAGING ON PROGNOSTIC OUTCOMES IN ATHLETES WITH CERVICAL CANCER: A COMPARATIVE STUDY WITH 2009 GUIDELINES

Abstract

Objective: To evaluate and compare the prognostic accuracy and distribution differences between the 2009 and 2018 FIGO cervical cancer staging systems in female athletes, assessing the applicability of the updated staging for enhanced sports health management. This study also aims to identify significant prognostic factors in this specific population. Methods: A retrospective cohort of 619 female athletes diagnosed with cervical cancer at the Second Affiliated Hospital of Soochow University from January 2010 to December 2020 was analyzed. Patient demographics, clinical data, and outcomes were collected and categorized according to both the 2009 and 2018 FIGO staging criteria. Survival analyses were conducted using the Kaplan-Meier method, with the Log-rank test applied to assess differences in prognosis across stages. Cox regression was utilized to determine independent prognostic factors. Results: A strong positive correlation was observed between the staging systems, with Kendall's tb=0.679 (P<0.001). Significant statistical differences were noted in overall survival (OS) and progression-free survival (PFS) across different stages, particularly between the 2018 revisions. The 2018 FIGO staging demonstrated improved differentiation in survival outcomes among athletes, especially between early and advanced stages. Notably, hemoglobin levels prior to treatment emerged as an independent risk factor for OS. Differences in treatment modalities also showed a significant impact on PFS in athletes staged with 2018 FIGO criteria, highlighting the influence of sports-related health management on outcomes. Conclusion: The 2018 FIGO staging system offers greater prognostic accuracy and is more effective in distinguishing between different prognostic groups in female athletes with cervical cancer compared to the 2009 system. This suggests a significant benefit in tailoring cancer management strategies specific to female athletes, potentially incorporating sports health management practices to improve outcomes. The findings underscore the need for further research into sport-specific adaptations in cancer treatment protocols to enhance prognosis and recovery in athletic populations.