Article Text
Abstract
Introduction The aim of this study was to investigate the impact of the stage shift from FIGO 2009 to FIGO 2023 on the adjuvant management and survival of carcinoma endometrium.
Methods Data of patients with endometrial cancer from January 2018 to December 2020 treated at a single institution in Southern India was anlased looking at variables such as demographic data as well as stage distribution according to FIGO 2009 and FIGO 2023 criteria. The treatment received (surgery, radiation, chemotherapy), and survival rates (overall survival and disease-free survival) were investigated.
Results Of the 244 patients during the study period, the stage distribution according to 2009 FIGO staging was IA (59%), IB (20%), II (5%), IIIA (1%), IIIB (0.5%), IIIC1(5%), IIIC2(7%), IVB (2.5%). Upon re-assigning of stage as per FIGO 2023 staging ,43(17.6%) was upstaged from stage IA (2009) to IIB in 4 (1.5%) and IIC in 16 (6.5%). Amongst the stage IB (2009), 2(0.8%) were upstaged to IIB and 15(6.1%) were upstaged to IIC. In stage II the upstaging was to IIB in 5 (2.1%) and IIC in 1 (0.4%). Among those upstaged there were no cases which were undertreated as our institutional protocol included aggressive treatment for deep myometrial invasion and significant LVSI even in early stages. The median OS was 61.2 mths and RFS was 59 months.
Conclusion/Implications The new staging draws attention to finer detail to the tumour aspects such as LVSI, myometrial invasion and tumour type. FIGO 2023 staging has a role in adjuvant treatment decisions and hence survival figure 1