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EP180/#587  Validation of the 2023 FIGO endometrial cancer staging system
  1. Hiroshi Yoshida1,
  2. Hiroko Machida1,
  3. Koji Matsuo2,
  4. Yoshito Terai3,
  5. Takuma Fujii4,
  6. Masaki Mandai5,
  7. Kei Kawana6,
  8. Hiroaki Kobayashi7,
  9. Satoru Nagase8 and
  10. Mikio Mikami1
  1. 1Tokai University School of Medicine, Obstetrics and Gynecology, Isehara, Japan
  2. 2University of Southern California,, Gynecologic Oncology, Los angeles, USA
  3. 3Kobe University, Obstetrics and Gynecology, Hyogo, Japan
  4. 4Fujita Health University School of Medicine, Obstetrics and Gynecology, Toyoake, Japan
  5. 5Graduate School of Medicine, Kyoto University, Gynecologic Oncology, Kyoto, Japan
  6. 6Nihon University School f medicine, Obstetrics and Gynecologyynecology, Tokyo, Japan
  7. 7Kagoshima University, Obstetrics and Gynecology, Kagoshima, Japan
  8. 8Yamagata University Faculty of Medicine, Gynecologic Oncology, yamagata, Japan


Introduction Objective: To validate the revised 2023 International Federation of Gynecology and Obstetrics (FIGO) endometrial cancer staging system, focusingon stage I and II diseases.

Methods Endometrial cancer patients[A1] who received minimally invasive surgery between 2015 and 2017 were enrolled in a retrospective cohort research utilizing the Japan Society of Obstetrics and Gynecology Tumor Registry database. [A2] Stage I disease comprisedIA1 (tumor limited to the endometrium), IA2 (< half ofmyometrial invasion [MI] without LVSI [A3] in non-aggressive tumor), IA3 (low-grade endometrioid tumor limited to the uterus and ovary), and IB (more than half of MI without LVSI in a non-aggressive tumor). Stage II comprisedIIA (stromal invasion), IIB (substantial LVSI), and IIC (aggressive tumor with MI). Multivariable analysis was performed for survival assessment based on cancer stage.

Results In stage I (n=2937), IA2 was not associated with an increased mortality risk rate compared to IA1 (adjusted hazard ratio [aHR], 1.04;95% confidence interval [CI],0.55–[A1] 1.96;P=0.902). IA3 and IB were independently associated with an increased mortality risk (aHR, 3.8; 95%CI, 1.01–14.30;P=0.048; andaHR, 2.39;95%CI, 1.04–5.48;P=0.039, respectively[A2] ) compared to IA1. In stage II (n=696), IIB had a worse, though non-significant, survival rate tendency compared to IIA (aHR,5.35;95%CI,0.74–39.34;P=0.099). IIC was independently associated with an increased mortality rate (aHR, 14.86;95%CI, 2.02–106.8;P=0.008).

Conclusion/Implications The 2023 FIGO staging system for endometrial cancer might be useful to distinguish survival groupsamongstagesIA3, IB, IIA, IIB, and IIC.

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