CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2025; 85(04): 405-416
DOI: 10.1055/a-2494-8395
GebFra Science
Review

New FIGO 2023 Staging System of Endometrial Cancer: An Updated Review on a Current Hot Topic

Neues FIGO-2023-Staging-System für das Endometriumkarzinom: eine aktualisierte Übersicht über ein aktuelles Topthema
Borek Sehnal 
1   Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague 10, Czech Republic
,
Martin Hruda 
1   Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague 10, Czech Republic
,
Radoslav Matej 
2   Department of Pathology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague 10, Czech Republic
3   Department of Pathology and Molecular Medicine, Thomayer University Hospital and Third Faculty of Medicine, Charles University, Prague 4, Czech Republic (Ringgold ID: RIN48209)
4   Department of Pathology, General University Hospital in Prague and First Faculty of Medicine, Charles University, Prague 2, Czech Republic
,
Helena Robova 
1   Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague 10, Czech Republic
,
Jana Drozenova
2   Department of Pathology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague 10, Czech Republic
,
Tomas Pichlik 
1   Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague 10, Czech Republic
,
Michael J. Halaska 
1   Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague 10, Czech Republic
,
Lukas Rob 
1   Department of Obstetrics and Gynaecology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague 10, Czech Republic
,
Pavel Dundr 
4   Department of Pathology, General University Hospital in Prague and First Faculty of Medicine, Charles University, Prague 2, Czech Republic
› Author AffiliationsSupported by: lékařská fakulta Univerzity Karlovy Cooperatio program Medical Diagnostics, Cooperatio program, Maternal and Childhood Care No
Supported by: Ministerstvo Zdravotnictví Ceské Republiky FTN 00064190, Grant Nr. NW24-09-00505, VFN 00064165
› Further Information
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Abstract

The International Federation of Gynaecology and Obstetrics (FIGO) introduced a new staging system for endometrial carcinoma FIGO 2023 in June 2023. The new staging system differs significantly from previous versions by incorporating other non-anatomical parameters (histological type of tumour, tumour grade and the presence of massive lymphovascular space involvement as well as the molecular classification of the tumour). The FIGO 2023 staging system enhances the accuracy of prognostic assessments for patients at a specific stage with better options for targeted treatment. Another objective was to synchronise staging as much as possible with the European oncogynaecological ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma established in 2021. However, several changes are controversial. Routine molecular classification of endometrial carcinomas is not yet commonly available in most countries of the world. Another limitation of the FIGO 2023 staging system of endometrial cancer is the inclusion of variables whose definitions are still evolving, as well as variables that are subject to considerable interobserver variability in their assessment. Advantages, controversies, and limitations for clinical practice of the new FIGO 2023 endometrial cancer staging system are discussed.

Zusammenfassung

Im Juni 2023 hat die Internationale Vereinigung für Gynäkologie und Geburtshilfe (FIGO) ein neues Staging-System für das Endometriumkarzinom – FIGO 2023 – eingeführt. Das neue Staging-System unterscheidet sich signifikant von früheren Versionen, da nun auch andere nicht anatomische Parameter (z. B. histologischer Tumortyp, Tumorgrad, ausgedehnter Befall des lymphatischen Raums sowie die molekulare Klassifikation von Tumoren) einbezogen wurden. Das FIGO-2023-Staging-System verbessert die prognostische Genauigkeit bei Patientinnen in einem bestimmten Tumorstadium mit einer besseren Auswahl an gezielten Behandlungsmöglichkeiten. Zweck des neuen Systems ist es auch, das FIGO-Staging weitmöglichst mit dem Staging der gynäkologisch-onkologischen Europäischen Leitlinien der ESGO/ESTRO/ESP, die im Jahre 2021 für das Management von Patientinnen mit Endometriumkarzinom aufgestellt wurden, in Einklang zu bringen. Allerdings werden mehrere Änderungen immer noch kontrovers diskutiert. So ist in den meisten Ländern der Welt die routinemäßige molekulare Klassifikation von Endometriumkarzinomen nicht allgemein üblich oder erhältlich. Eine weitere Einschränkung des FIGO-2023-Staging-Systems für das Endometriumkarzinom ist die Einbeziehung von Variablen, deren Definitionen noch im Entstehen begriffen sind, bzw. von Variablen, die eine erhebliche Interobserver-Variabilität aufweisen. Die Vorteile, Kontroversen und Einschränkungen des neuen FIGO-2023-Staging-Systems in der klinischen Praxis werden hier diskutiert.

Keywords

staging - staging system - FIGO 2023 - endometrial cancer - molecular classification - ESGO - ESTRO - ESP - controversies

Schlüsselwörter

Staging - Staging-System - FIGO 2023 - Endometriumkarzinom - molekulare Klassifikation - ESGO - ESTRO - ESP - Kontroversen


Publication History

Received: 29 August 2024

Accepted after revision: 30 November 2024

Article published online:
16 January 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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