Verification of the prognostic precision of the new 2023 FIGO staging system in endometrial cancer patients – An international pooled analysis of three ESGO accredited centres

• DOI: 10.1016/j.ejca.2023.113317
• Publication Date: 2023-09-01T01:17:19Z
• Authors: Richard Schwameis; Francesco Fanfani; Christoph Ebner; Naomi Zimmermann; Inge Peters; Camilla Nero; Christian Marth; Robin Ristl; Katharina Leitner; Christoph Grimm; Felicitas Oberndo...; Ilaria Capasso; Alain G. Zeimet; Stephan Polterauer; Giovanni Scambia; Anna Fagotti; Nicole Concin
• Keywords: Endometrial cancer; Prognostic precision; Molecular classification; 2023 FIGO staging system; Stage shift; 2009 FIGO staging system; 3. Good health

Recently, the new 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer (EC) critically integrating pathological molecular features was published. The present study evaluated clinical impact FIGO by comparing it to previous 2009 system.This is an international, pooled retrospective 519 EC patients who underwent primary treatment (and characterisation) at three European Society Gynaecological Oncology (ESGO) accredited centres in Austria/Italy. Patients were categorised according systems. Stage shifts analysed (sub)stage specific 5-year progression-free (PFS) overall survival (OS) rates calculated compared. Different statistical tests applied evaluate prognostic precision two systems compare them each other.(Sub)stage occurred 143/519 (27.6%) patients: 123 upshifts (23.7%) 20 (3.9%) downshifts. identified a stage I cohort with notably higher PFS rate compared (93.0% versus 87.4%, respectively). For II disease, similar (70.2% 71.2%, molecularly defined substages IAmPOLEmut IICmp53abn displayed distinct, particularly favourable adverse oncologic outcomes within early respectively. A remarkably lower III revealed (44.4% 54.1%, All confirmed more accurate prediction OS 2009.The stating led substantial shift about one quarter leading precision. In added further granularity relevant subgroups.