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  • #809 Verification of the prognostic precision of the new 2023 FIGO staging system in endometrial cancer patients– an international pooled analysis of three ESGO accredited centers

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Late Breaking Abstracts
03. Endometrial cancer
#809 Verification of the prognostic precision of the new 2023 FIGO staging system in endometrial cancer patients– an international pooled analysis of three ESGO accredited centers
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  1. Richard Schwameis1,
  2. Francesco Fanfani2,
  3. Christoph Ebner3,
  4. Naomi Zimmermann1,
  5. Inge Peters2,
  6. Camilla Nero2,
  7. Christian Marth3,
  8. Robin Ristl4,
  9. Katharina Leitner3,
  10. Christoph Grimm1,
  11. Felicitas Oberndorfer5,
  12. Ilaria Capasso2,
  13. Alain Zeimet3,
  14. Stephan Polterauer1,
  15. Giovanni Scambia2,
  16. Anna Fagotti2 and
  17. Nicole Concin3
  1. 1Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecological Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
  2. 2Department of Woman’s and Child health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS; Catholic University of the Sacred Heart, Rome, Italy
  3. 3Department of Obstetrics and Gynecology; Medical University Innsbruck, Innsbruck, Austria
  4. 4Center for Medical Data Science, Institute of Medical Statistics; Medical University of Vienna, Vienna, Austria
  5. 5Department of Pathology; Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria

Abstract

Introduction/Background Recently, the new 2023 FIGO staging system for endometrial cancer (EC) critically integrating new pathological and molecular features was published. The present study evaluated the clinical impact of the new 2023 FIGO staging system by comparing it to the previous 2009 system.

Methodology This is an international, pooled retrospective study of 519 EC patients who underwent primary treatment (and molecular characterization) at three ESGO accredited centers (Medical Universities of Innsbruck and Vienna and Catholic University of the Sacred Heart, Rome). Patients were categorized according to the 2009 and the 2023 FIGO staging system. Stage shifts were analyzed and (sub)stage specific 5-year progression-free (PFS) and overall survival (OS) rates were calculated and compared.

Results (Sub)stage shifts occurred in 144/519 (27.6%) patients: 123 upshifts (23.6%) and 20 (3.9%) downshifts. 2023 FIGO staging system identified a stage I cohort with a notably higher 5-year PFS rate compared to 2009 (93.0% versus 87.4%, respectively). For stage II disease, the 5-year PFS rate was slightly lower in the 2023 FIGO staging system compared to 2009 (70.2% versus 71.2%, respectively). The two new molecularly defined 2023 FIGO substages IAmPOLEmut and IICmp53abn displayed distinct, particularly favorable and adverse oncologic outcomes within early stage disease, respectively. A remarkably lower 5-year PFS rate for stage III patients was revealed in the 2023 FIGO staging system compared to 2009 (44.4% versus 54.1%, respectively).

Conclusion The new 2023 FIGO stating system led to a substantial stage shift in about one quarter of patients leading to a higher prognostic precision. In early stage disease the new substages added further prognostic granularity and identify treatment relevant subgroups.

Abstract #809 Figure 1
Abstract #809 Figure 1

Disclosures The authors have nothing to disclose.

https://doi.org/10.1136/ijgc-2023-ESGO.890

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