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 1–2).
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.
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