Prognostic performance of the 2023 FIGO staging schema for endometrial cancer.
Gynecol Oncol
; 187: 37-45, 2024 May 06.
Article
en En
| MEDLINE
| ID: mdl-38713997
ABSTRACT
OBJECTIVE:
To assess the prognostic performance of the 2023 International Federation of Gynecology and Obstetrics (FIGO) endometrial cancer staging schema.METHODS:
This retrospective cohort study queried the Commission-on-Cancer's National Cancer Database. Study population was 129,146 patients with stage I-IV endometrial cancer per the 2009 FIGO staging schema. Stage-shifting and overall survival (OS) were assessed according to the 2023 FIGO staging schema.RESULTS:
Upstage (IAâ¯ââ¯II, 21.4â¯%; IBâ¯ââ¯II, 53.0â¯%) and downstage (IIIAâIA3, 22.2â¯%) occurred in both early and advanced diseases. Inter-stage prognostic performance improved in the 2023 schema with widened 5-year OS rate difference between the earliest and highest stages (68.2â¯% to 76.9â¯%). Stage IA1-IIB and IIC had distinct 5-year OS rate differences (85.8-96.1â¯% vs 75.4â¯%). The 5-year OS rate of the 2009 stage IIIA disease was 63.9â¯%; this was greater segregated in the 2023 schema 88.0â¯%, 62.4â¯%, and 55.7â¯% for IIIAâIA3, IIIA1, and IIIA2, respectively (inter-substage rate-difference, 32.3â¯%). This 5-year OS rate of stage IA3 disease was comparable to the 2023 stage IB-IIB diseases (88.0â¯% vs 85.8-89.5â¯%). In the 2023 stage IIIC schema (micrometastasis rates 29.6â¯% in IIIC1 and 15.6â¯% in IIIC2), micrometastasis and macrometastasis had the distinct 3-year OS rates in both pelvic (IIIC1-i vs IIIC1-ii, 84.9â¯% vs 71.1â¯%; rate-difference 13.8â¯%) and para-aortic (IIIC2-i vs IIIC2-ii, 82.9â¯% vs 65.2â¯%; rate-difference 17.7â¯%) nodal metastasis cases. The 5-year OS rate of the 2009 stage IVB disease was 23.4â¯%; this was segregated to 25.4â¯% for stage IVB and 19.2â¯% for stage IVC in the 2023 staging schema (rate-difference, 6.2â¯%).CONCLUSION:
The 2023 FIGO endometrial cancer staging schema is a major revision from the 2009 FIGO schema. Almost doubled enriched sub-stages based on detailed anatomical metastatic site and incorporation of histological information enable more robust prognostication.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Idioma:
En
Revista:
Gynecol Oncol
Año:
2024
Tipo del documento:
Article