鉴于子宫内膜癌（EC）发病率的上升，人们已努力对患者进行更好的风险分层。 2023年FIGO分期现在将组织学亚型和分子分类纳入EC分期的确定中。我们试图阐明新的分期系统与 2009 年分期系统相比是否表现出预后差异。对 2013 年 9 月至 2023 年 5 月在我们机构接受 EC 治疗的女性进行了回顾性图表审查，并结合公开的 TCGA Nature 2013 数据集。捕获了详细的临床信息。根据 2023 年指南对患者进行重新分期。使用 Kaplan-Meier 方法获得生存估计，并使用时序检验比较无进展生存 (PFS) 的生存曲线。我们的分析中纳入了 919 名患者。数据集在组织学分级、分期和诊断年龄方面具有可比性。机构数据集中的 175 名患者 (31.5%) 和 TCGA 数据集中的 115 名患者 (31.6%) 经历了阶段变化。大多数分期改变的患者的分期被上调（275/290；94.8%）。没有分期改变的 IA 期患者与分期上调的 IA 期患者的 3 年 PFS 估计分别为 92.3% (95% CI: 87.2, 95.4) vs. 72.0% (95% CI: 68.4, 84.9)，p = 0.002。在其他分期亚组中未发现生存差异显着。最初分期为 IA 的 EC 患者在接受升期后存在适度的生存差异。在重新分期至 II 期或 III 期亚组的患者中，未观察到显着的生存差异。在评估子宫内膜癌患者的预后和辅助治疗时需要改进风险分层。版权所有 © 2024。由 Elsevier Inc. 出版。

Efforts have been made to better risk stratify patients given the rise in incidence of endometrial cancer (EC). The 2023 FIGO staging now incorporates histologic subtype and molecular classification into determination of EC stage. We sought to elucidate if the new staging system demonstrated prognostic differences compared to the 2009 staging system.A retrospective chart review was performed on women treated for EC at our institution from September 2013 to May 2023 and combined with the publicly available TCGA Nature 2013 dataset. Detailed clinical information was captured. Patients were restaged according to the 2023 guidelines. Survival estimates were obtained using Kaplan-Meier method, and the log-rank test was used to compare survival curves for progression-free survival (PFS).919 patients were included in our analysis. The datasets were comparable regarding histologic grade, stage, and age at diagnosis. 175 (31.5%) of patients in the institution dataset and 115 (31.6%) patients in the TCGA dataset experienced a stage change. Most patients whose stage changed were upstaged (275/290; 94.8%). 3-year PFS estimates for stage IA patients with no stage change versus those upstaged were 92.3% (95% CI: 87.2, 95.4) v. 72.0% (95% CI: 68.4, 84.9), p = 0.002. No significant differences in survival difference were seen in other stage subsets.Modest survival differences exist in patients with EC originally staged as IA who underwent upstaging. No significant survival difference is observed in patients who are restaged to stage II or III subsets. Improved risk stratification is needed in assessing prognosis and adjuvant therapy for patients with endometrial cancer.Copyright © 2024. Published by Elsevier Inc.