FIGO 2023 staging system predicts not only survival outcome but also recurrence pattern in corpus-confined endometrial cancer patients

IF 2 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Taiwanese Journal of Obstetrics & Gynecology Pub Date : 2025-01-01 DOI:10.1016/j.tjog.2024.09.020

Hua-Hsi Wu , Hung-Tse Chou , Shih-Yao Lin , Chiung-Ru Lai , Yi-Jen Chen

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引用次数: 0

Abstract

Objective

Approximately 10–15 % of endometrial cancer patients with tumors confined to the uterus (FIGO 2009 stage I) demonstrate recurrence and the oncologic outcomes are highly related to recurrence patterns. This study aimed to verify whether the FIGO 2023 staging system could discriminate outcomes.

Materials and methods

Between January 2010 and March 2019, 536 FIGO 2009 stage I patients were eligible for this retrospective cohort study. Patient characteristics and clinicopathological data were retrieved from electronic medical records. The patients were reclassified according to the FIGO 2023 staging criteria. Oncological outcomes included the recurrence rate, recurrence pattern, and overall survival.

Results

Among the 536 eligible patients, the (sub)stage migration rate was 23.5 % from the FIGO 2009 to the FIGO 2023 stage system. FIGO 2023 staging system resulted in (sub)stage up-migration, mostly owing to aggressive histological types. A higher recurrence rate was detected in the FIGO 2023 stage II patients (12.3 %) compared to the stage I patients (6.9 %). In comparison to the FIGO 2023 stage I patients, the stage II patients had a higher distant recurrence rate (8.8 % vs. 2.6 %) and poorer overall survival (38.0 vs 69.0 months, p = 0.02).

Conclusion

Patients who are upstaged are prone to worse oncological outcomes, including distant recurrence and mortality. Therefore, comprehensive adjuvant treatment strategies based on each FIGO 2023 substage are imperative.

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FIGO 2023分期系统不仅可以预测体局限性子宫内膜癌患者的生存结果，还可以预测复发模式。

目的：约10- 15%的子宫内膜癌患者肿瘤局限于子宫（FIGO 2009期）复发，肿瘤预后与复发方式高度相关。本研究旨在验证FIGO 2023分期系统是否可以区分结果。材料和方法：2010年1月至2019年3月期间，536名FIGO 2009期I期患者入选了这项回顾性队列研究。从电子病历中检索患者特征和临床病理资料。根据FIGO 2023分期标准对患者进行重新分类。肿瘤预后包括复发率、复发模式和总生存期。结果：在536例符合条件的患者中，FIGO 2009分期系统向FIGO 2023分期系统的（亚）分期迁移率为23.5%。FIGO 2023分期系统导致（亚）期上迁移，主要是由于侵袭性组织学类型。FIGO 2023 II期患者的复发率（12.3%）高于I期患者（6.9%）。与FIGO 2023 I期患者相比，II期患者有更高的远处复发率（8.8% vs 2.6%）和更差的总生存期（38.0 vs 69.0个月，p = 0.02）。结论：被抢风头的患者易出现较差的肿瘤预后，包括远处复发和死亡率。因此，基于FIGO 2023各亚阶段的综合辅助治疗策略势在必行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Taiwanese Journal of Obstetrics & Gynecology OBSTETRICS & GYNECOLOGY-

CiteScore

3.60

自引率

23.80%

发文量

207

审稿时长

4-8 weeks

期刊介绍： Taiwanese Journal of Obstetrics and Gynecology is a peer-reviewed journal and open access publishing editorials, reviews, original articles, short communications, case reports, research letters, correspondence and letters to the editor in the field of obstetrics and gynecology. The aims of the journal are to: 1.Publish cutting-edge, innovative and topical research that addresses screening, diagnosis, management and care in women''s health 2.Deliver evidence-based information 3.Promote the sharing of clinical experience 4.Address women-related health promotion The journal provides comprehensive coverage of topics in obstetrics & gynecology and women''s health including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. Taiwan Association of Obstetrics and Gynecology.