Comparison of FIGO 1989 and 2009 recommendations on staging of endometrial carcinoma: pathologic analysis and cervical status in 123 consecutive cases.

ABSTRACT

Incidences of endometrial carcinoma (EC) among women of Western countries is increasing, reaching a level of 18/100,000. In 2009, the International Federation of Gynecology and Obstetrics (FIGO) proposed a new staging system in EC. The purpose of this study included the evaluation of distribution of EC in categories of age, histologic grade, and surgical staging according to the 1989 and the 2009 FIGO guidelines. The original staging assessments have been updated to reflect the current staging system in 123 consecutive patients. Statistical analysis was carried out. The median age of patients was 61 years. A comparison of old and new staging systems shows that a significant number of patients moved to stage I 78.05%, versus 56.91% based on the 1989 classification (P=0.044). The number of patients in stage II changed as well 9.76% according to new staging system and 30.89% by definitions of FIGO 1989 (P=0.001). Of patients in stage II, 21.1% had G1 tumors according to the old versus 8.3% by the new classification (P=0.001). We have not identified any associations between the histologic status of a cervix and EC. The most common type of EC is the endometrioid subtype, found in 87.8% of patients. We have noted a significant association between the tumor grade and cervical stromal infiltration. The new classification system for EC seems to be an improved staging instrument. Having up to 80% of patients with endometrial cancer in stage I and following them, might elucidate the impact of current staging on survival and life quality.