Introduction FIGO staging for endometrial cancer will be revised in 2023. The novel staging will include major changes such as the addition of lymphovascular invasion and histological type. The aim of this study is to evaluate the revised FIGO2023 staging.

Methods This study included 1,006 patients diagnosed with endometrial cancer between 2012 and 2021 at our institution. We analyzed them based on the pTNM classification and clinicopathological factors.

Results Under the FIGO2023 classification, 59.7% of patients were classified as stage I (26.9% were classified as IA1, 27.4% as IA2, 0.5% as IA3, and 4.9% as IB), 23.2% as stage II (1.8% as IIA, 14.2% as IIB, and IIC as 7.2%), 12.0% as stage III (1.0% as IIIA1, 0.7% as IIIA2, 1.1% as IIIB1, 0.5% as IIIB2, 3.4% as IIIC1, and 5.4% as IIIC2), and 5.1% as stage IV (0.1% as IVA, 2.6% as IVB, and 2.4% as IVC). Among stage I, the 5-year overall survival rate (5y-OS) was 99.1% in IA1, 99.2% in IA2, 100% in IA3, and 100% in IB. Among stage II, the 5y-OS was 100% in stage IIA, 93.2% in IIB, and 85.2% in IIC. Among stage III, the 5y-OS was 100% in stage IIIA1, 66.7% in IIIA2, 66.7% in IIIB1, 100% in IIIB2, 84.2% in IIIC1, and 84% in IIIC2. Finally, the 5y-OS was 100% in stage IVA, 46.2% in IVB, and 33.3% in IVC among stage IV.

Conclusion/Implications These findings indicate that the revised staging will result in upstaging of some cases with high-grade histologies and positive lymphovascular invasion.