YING HAN

and 5 more

Objectives We compared the utility of 2009 and 2023 FIGO stage system in our center with endometrial carcinoma. Methods A total of 172 patients between 2015 and 2020 diagnosed with endometrial carcinoma in our center was included in this study. Molecular classification subtypes were classified using DNA sequencing and immunohistochemostry. The clinical characteristics and patients prognosis were analyzed. Results Of the 172 patients, 10 patients were classified to the POLE-EDM group, 30 patients to the MMR-D group, 106 patients to the NSMP group, and 26 patients to the p53abn group. Stage migration from FIGO2009 to FIGO2023 occurred in 27.3% of the patients (47/172). Among the 47 patients, upstaging from stage I to stage II was observed in 43 patients. The transition from stage III to the early stage occurred in only two patients. All patients were downstaged from III to IA3. Subsequently, from FIGO2023 to FIGO2023m, 9 patients had stage IAm disease. Downstaging to stage IAm was observed in 7 patients due to the presence of POLE mutation. In addition, 14 patients had stage IICm disease using FIGO 2023m. 8 patients were upstaged to stage IIC m due to the presence of p53 abnormality, while 6 patients already exhibited stage IIC disease based on the FIGO2023 classification, without molecular classfication. Patients with endometrial cancer with POLE-EDM had the best prognosis in terms of RFS and OS; those with MMR-D and NSMP exhibited intermediate prognosis, with no significant difference between the two groups; and those with p53abn had the worst prognosis. Conclusions Molecular classifier is a useful tool for classifying endometrial carcinoma and determining prognosis. FIGO2023m showed great advantage in predict prognostic in all stages.