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SO023LBA/#1384  Prognostic performance of the 2023 FIGO staging schema for endometrial cancer
  1. Hiroko Machida1,
  2. Ling Chen2,
  3. Maximilian Klar3,
  4. Matthew Lee2,
  5. Mikio Mikami1,
  6. Laila Muderspach4,
  7. Joseph Carlson5,
  8. Lynda Roman4,
  9. Koji Matsuo4 and
  10. Jason Wright6
  1. 1Tokai University School of Medicine, Obstetrics and Gynecology, Isehara, Japan
  2. 2Columbia University College of Physicians and Surgeons, Department of Obstetrics and Gynecology, New York, USA
  3. 3University of Freiburg Faculty of Medicine, Department of Obstetrics and Gynecology, Freiburg, Germany
  4. 4University of Southern California,, Gynecologic Oncology, Los angeles, USA
  5. 5University of Southern California,, Department of Pathology, Los angeles, USA
  6. 6Columbia University, Obstetrics and Gynecology, New York City, USA


Introduction This study examined prognostic performance of the 2023 FIGO endometrial cancer staging schema.

Methods The National Cancer Database was retrospectively queried to examine 129,146 patients with stage I-IV endometrial cancer per the 2009 FIGO schema. Overall survival (OS) per the 2023 FIGO schema was assessed (figures 12).

Results In the 2009 schema, the inter-stage difference in 5-year OS rate was 68.2% (91.4% for IA and 23.4% for IVB; this widened to 74.9% in the 2023 schema (94.1% for IA1 and 19.2% for IVC). In the 2023 schema, 5-year OS rate of IIC was more than 10%-point lower compared to that of IA-IB (74.7% vs 88.0–94.4%). In the 2009 schema, 5-year OS rate of IIIA was 63.9%; this was greater segregated to 88.0% for IA3, 62.9% for IIIA1, and 55.7% for IIIA2 in the 2023 schema. This 5-year OS rate of new IA3 was comparable to IB in the 2023 schema (88.0% vs 89.5%). In the 2023 schema, irrespective to nodal metastatic sites, 3-year OS rates were similar in micrometastasis (IIIC1-i vs IIIC2-i, 84.9% vs 82.9%) but not in macrometastasis (IIIC1-ii vs IIIC2-ii, 71.1% vs 65.2%). In the 2009 schema, the 5-year OS rate of IVB was 23.4%; this was segregated to 25.4% for IVB and 19.2% for IVC in the 2023 schema.

Conclusion/Implications The 2023 FIGO endometrial cancer staging schema is a major revision from the 2009 FIGO schema. Almost doubled enriched sub-stages based on detailed anatomical metastatic site and incorporation of histological information enable more robust prognostication.

Abstract SO023LBA/#1384 Figure 1
Abstract SO023LBA/#1384 Figure 2

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