Clinical calculator summary
Original GOG-92 Sedlis Criteria
Clinical calculator summary
Original GOG-92 Sedlis Criteria
Four postoperative intermediate-risk combinations using LVSI, stromal invasion depth, and raw clinical tumor diameter.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the original Sedlis criteria only after the historical postoperative eligibility requirements are confirmed.
- Population:
- Selected FIGO stage IB cervical carcinoma after radical hysterectomy and pelvic lymphadenectomy with negative nodes, margins, and parametria.
- Factors:
- LVSI, Stromal invasion depth, Clinical tumor diameter, Surgical context, Nodes, Margins, Parametria
- Reference:
- Sedlis et al. Gynecol Oncol. 1999;73:177-183.
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Sedlis Criteria (Cervical)
Clinical Context & Background
This calculator implements the original 1999 GOG-92 Sedlis criteria for selected patients with FIGO stage IB cervical carcinoma after radical hysterectomy and pelvic lymphadenectomy. It requires negative pelvic nodes, surgical margins, and parametria before applying the four combinations of lymphovascular space invasion (LVSI), stromal invasion depth, and clinical tumor diameter.
Clinical tumor diameter is used without rounding. Positive nodes, margins, or parametrial involvement are high-risk postoperative features outside the Sedlis intermediate-risk pathway. Unknown eligibility or a different surgical context makes the historical criteria not applicable. A nonmatching combination is described only as "criteria not met," not as low risk.
The criteria do not stage cervical cancer or automatically prescribe or omit radiotherapy. Apply current guidelines and multidisciplinary assessment, particularly for uncommon histologies, recurrent or unresected disease, fertility-sparing or simple hysterectomy, and definitive chemoradiation settings.
Formula Logic
Original 1999 GOG-92 Sedlis criteria: LVSI positive with deep-third invasion at any positive clinical diameter; LVSI positive with middle-third invasion at >=2 cm; LVSI positive with superficial-third invasion at >=5 cm; or LVSI negative with middle- or deep-third invasion at >=4 cm.Reference Data
| LVSI | Stromal invasion | Clinical tumor diameter |
|---|---|---|
| Positive | Deep third | Any positive size |
| Positive | Middle third | >=2 cm |
| Positive | Superficial third | >=5 cm |
| Negative | Middle or deep third | >=4 cm |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use only after radical hysterectomy and pelvic lymphadenectomy in the historical source context.
- Confirm negative pelvic nodes, surgical margins, and parametria before applying the four intermediate-risk combinations.
How To Interpret
- Criteria met means the eligible profile matches one original GOG-92 combination.
- Criteria not met is not a low-risk label and does not automatically support observation.
- A high-risk postoperative feature or unconfirmed eligibility is reported separately rather than forced into the Sedlis decision table.
What To Do Next
- Document the source variables and eligibility assessment.
- Integrate histology, contemporary stage, pathology, patient factors, current guidelines, and multidisciplinary gynecologic and radiation oncology review.
Limitations
- Historical FIGO stage IB postoperative population; do not automatically translate modern FIGO categories into this cohort.
- Do not apply automatically to uncommon histologies, unresected or recurrent disease, definitive chemoradiation, fertility-sparing surgery, or simple hysterectomy.
- The result does not prescribe or omit radiotherapy.
Validated Population
Historical GOG-92 stage IB cervical carcinoma after radical hysterectomy and pelvic lymphadenectomy with negative nodes, margins, and parametria.
Middle-third boundary
With confirmed eligibility, LVSI-positive middle-third invasion and a raw clinical diameter of exactly 2.0 cm meets the original criterion; 1.99 cm does not.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Five source-backed GOG-92 cases were exercised on the published route through visible controls; 5/5 expected results matched, including both sides of the 2 cm and 5 cm decision boundaries.
- No unexpected N/A, literal undefined trace value, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/sedlis-radiation-cervical-2026-08-03.json.
: Local browser remediation verified; production retest pending
- Supplied source-defined decision text to the result breakdown so the visible explanation no longer renders literal undefined entries.
- Ten local browser cases passed through visible controls across all four original GOG-92 combinations, exact raw boundaries, high-risk and insufficient-context outcomes, and reset/repeat behavior.
- The original failed production-browser record remains open until this change is deployed and the public route passes a new ten-case browser run.
Local diagnostic evidence is retained in validation/browser-production/sedlis-radiation-cervical.local-remediation.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 0/10 case records passed their expected-versus-observed assertions across 0 visible submissions.
- Overall browser status: failed-ui. high: Every calculated result displayed literal `undefined` entries in the visible calculation trace after each criterion value. | medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/sedlis-radiation-cervical.json.
: Browser input adapter corrected and reverified
- Corrected the public form adapter so its normalized clinical tumor diameter reaches the unchanged seven-field Sedlis engine instead of returning N/A.
- All four published Sedlis reference combinations passed in the live local form; no rule, 2/4/5 cm boundary, eligibility gate, classification, or applicability behavior changed.
- The 320/320 Sedlis verification suite and calculator-wide browser-input audit passed.
: Input workflow simplified and revalidated
- Reduced the public form to result-, branch-, unit-, and applicability-changing inputs; removed or consolidated non-scoring, administrative, and duplicate questions.
- Preserved the verified calculation or report-interpretation logic, thresholds, model version, component logic, and supported result pathways behind strict deterministic adapters.
- Passed the calculator-specific regression audit, adapter-parity and malformed-input checks, the 144-calculator input-quality audit, and the 43-calculator entry-burden audit.
: Full validation test
- 320/320 source-rule, raw-boundary, eligibility, malformed-input, UI, trace, scope, report, registry, and isolation checks passed.
- No registered master panel calculates Sedlis; no panel receives inherited verification.
: Calculation and input-contract correction
- Removed favorable defaults and coercion; all seven fields are explicit, clinical diameter must be finite and positive, and the raw 2 cm, 4 cm, and 5 cm boundaries are enforced without an invented maximum.
- Added surgical, nodal, margin, and parametrial eligibility gates; separated high-risk and insufficient-eligibility outcomes; replaced low-risk and automatic-radiotherapy wording with source-limited interpretation.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
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Frequently Asked Questions
What must be confirmed before applying the Sedlis criteria?
The historical source context requires radical hysterectomy and pelvic lymphadenectomy with negative pelvic nodes, surgical margins, and parametria.
What happens when a high-risk postoperative feature is present?
Positive nodes, margins, or parametrial involvement make the Sedlis intermediate-risk pathway not applicable; use the appropriate current high-risk postoperative assessment.
Does criteria not met mean low risk or no radiotherapy?
No. It means only that the entered eligible profile does not match one of the four original GOG-92 combinations. It is not a low-risk label or an automatic treatment recommendation.
Evidence-based oncology decision support. Verify with clinical guidelines.