The 2009 staging system for endometrial cancer that focused on the extent and anatomic location of disease has been updated to include significant advancements in our understanding of the disease based on histological type and molecular classification.
Cancer staging systems classify malignant diseases based on specific tumor characteristics to facilitate providers’ understanding of the extent and severity of a patient’s cancer and to determine the most effective treatment options.
The new staging system comes from The International Federation of Gynecology and Obstetrics (FIGO) Committee on Women’s Cancer. FIGO is the world’s largest alliance of national societies of obstetrics and gynecology.
Prompted by these new advances and improved understanding of the disease, the FIGO committee appointed a Subcommittee on Endometrial Cancer Staging in late 2021, which reviewed current evidence on the treatment, prognosis, and survival of patients with endometrial cancer. Both the committee and subcommittee are chaired by Jonathan S. Berek, MD, MMSc, Stanford Cancer Institute leader, and Stanford Laurie Kraus Lacob Professor.
“The revised system underscores the importance of molecular classification in understanding and treating cancer,” says Berek.
The new 2023 staging system has four stages, each of which contains substages that are determined by the cancer’s histological and molecular characteristics. Molecular classifications in the new staging include POLEmut, MMRd, NSMP, and p53abn.
This system adds a more detailed subclassification of histological types and criteria to assess patterns of tumor spread to other organs in the body. With this information, the provider can recommend better treatments tailored to the specific type of endometrial cancer, enhancing the patient’s prognosis.
“Our hope is that the new system will lead to more evidence-based, comprehensive treatment plans and give patients a better quality of life, longer survival times, and improved chances for cure,” Berek said.
The subcommittee published their findings in the International Journal of Gynecology & Obstetrics.
Photo courtesy of Jonathan Berek