FIGO Staging of Endometrial Cancer: 2023
FIGO and IJGO are pleased to announce the publication of the FIGO Staging of Endometrial Cancer: 2023. This paper was written by the FIGO Endometrial Cancer Staging subcommittee and published in June 2023.
In October 2021, the FIGO Women’s Cancer Committee established the Endometrial Cancer Staging subcommittee to review new and established findings on endometrial cancer treatment, prognosis, and survival. The review aimed to revise the existing FIGO Staging System for Endometrial Cancer in order to incorporate essential new published evidence and improve understanding of the complex nature of endometrial cancers.
Highly anticipated update to the FIGO Staging System for Endometrial Cancer
The initial FIGO Staging System for Endometrial Cancer was published in 2009 and, since then, a wealth of information has emerged about the various histological types, tumour patterns and molecular classification of endometrial cancer.
This 2023 update serves to clarify the diverse biological nature of endometrial carcinomas and their differing prognostic outcomes, define these prognostic groups more clearly and create substages that allow for better-adapted treatment.
The updated 2023 Staging of Endometrial Cancer includes the various histological types, tumor patterns and molecular classification to better reflect our improved understanding of the complex nature of the several types of endometrial carcinoma and their underlying biologic behaviour.
The changes incorporated in the 2023 staging system should provide an evidence-based context for treatment recommendations and a more refined future collection of outcomes and survival data. We dedicate this staging system to all women diagnosed with endometrial cancer in the hope that it will help to improve their care and treatment.
– Professor Jonathan Berek, Chair, FIGO Committee on Women’s Cancer
Key changes and updates to the FIGO staging system
In the first instance, the article discusses the pathology of endometrial cancers, incorporating new findings surrounding the histological type, tumour grade, myometrial invasion, lymphovascular space invasion, cervical stromal invasion, adnexal involvement, uterine serosal involvement, lymph node status and molecular classification of endometrial carcinomas.
The article then discusses the many updates and new evidence that support changes to the current FIGO staging system, including the addition and expansion of various substages to better define the complex and varying types of endometrial carcinomas that can present in patients. It includes:
- Incorporation of risk stratification, as developed by the European Society of Gynaecological Oncology (ESGO), the European Society for Therapeutic Radiology and Oncology (ESTRO), and the European Society of Pathology (ESP), to help better define prognosis and therapeutic approaches.
- Inclusion of molecular measures to reflect the impact on prognosis of significant molecular parameters, similar to the 2018 breast cancer staging.
- Inclusion of the various histological types, tumour patterns, and molecular classification to better reflect the improved understanding of the complex nature of the several types of endometrial carcinoma and their underlying biologic behaviour.