国际妇产科联合会委员会根据组织病理学特征和分子谱修改了子宫内膜癌（EC）分期系统。目的是评估新的 2023 系统与之前的 2009 系统相比的临床意义。我们回顾性识别了 2014 年至 2018 年间在首尔国立大学医院接受初次手术治疗的 161 名 EC 患者。使用来自福尔马林固定、石蜡包埋块的组织进行 POLE 突变的液滴数字聚合酶链反应和 MLH1、PMS2、MS2、MSH6 和 p53 的免疫组织化学反应。所有患者均根据2009年和2023年分期系统进行分类。中位随访时间为62.9个月（范围，0.3-110.9），中位年龄为57.2岁（范围，28.0-85.9）。 2023系统分子分类的5年无进展生存率（PFS）为I期80.3%，II期75.2%，III期61.2%，IV期22.2%（p<0.001）。使用 2023 系统对 2009 年患有 I 期和 II 期疾病的患者进行了重新分期。相比之下，III期和IV期疾病患者被固定在2009年和2023年系统中。分子分类将 10 名患者 (71.4%) 降期至 IAmPOLEmut，将 6 名患者 (37.5%) 升期至 IICmp53abn。具有分子分类的 2023 年系统与 PFS 和总生存率相关（p<0.001 和 p=0.038）。与 2009 年系统相比，2023 年 EC 分期系统细分为 I ​​期和 II 期。 2023 年分子分类系统是生存率的良好预测指标。© 2024。亚洲妇科肿瘤学会、韩国妇科肿瘤学会和日本妇科肿瘤学会。

The International Federation of Gynecology and Obstetrics committee modified the endometrial cancer (EC) staging system based on the histopathological feature and molecular profile. The aim is to evaluate the clinical implications of the new 2023 system compared with the previous 2009 system.We retrospectively identified 161 patients with EC who underwent primary surgical treatment between 2014 and 2018 at Seoul National University Hospital. The droplet-digital polymerase chain reaction for POLE mutations and immunohistochemistry for MLH1, PMS2, MS2, MSH6, and p53 were performed using tissues from formalin-fixed, paraffin-embedded blocks. All patients were categorized according to the 2009 and 2023 staging systems.The median follow-up period was 62.9 months (range, 0.3-110.9), and the median age was 57.2 years old (range, 28.0-85.9). The 5-year progression-free survival (PFS) for the 2023 system with molecular classification was 80.3% for stage I, 75.2% for stage II, 61.2% for stage III, and 22.2% for stage IV (p<0.001). Patients with the 2009 stage I and II disease were restaged using the 2023 system. In contrast, patients with stage III and IV disease were fixed in the 2009 and 2023 systems. Molecular classification downstaged 10 patients (71.4%) to IAmPOLEmut and upstaged 6 patients (37.5%) to IICmp53abn. The 2023 system with molecular classification was associated with PFS and overall survival (p<0.001 and p=0.038).The 2023 staging system for EC subdivided stages I and II compared to the 2009 system. The 2023 system with molecular classification is a good predictor of survival.© 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.