Grosse Solène, Genestie Catherine, Scherier Stéphanie, Maulard Amandine, Pautier Patricia, Leary Alexandra, Michels Judith, Espenel Sophie, Dabreteau Thomas, Morice Philippe, Gouy Sébastien
Service de chirurgie gynécologique, Gustave-Roussy, 94805 Villejuif, France.
Service de pathologie morphologique, Gustave-Roussy, 94805 Villejuif, France.
Bull Cancer. 2025 Mar;112(3):335-339. doi: 10.1016/j.bulcan.2024.09.004. Epub 2024 Nov 13.
Since the last FIGO classification in 2009, numerous studies and recommendations have contributed to improving the management of endometrial cancer. The introduction of molecular classification (including POLE, MMR, and P53 status) has enabled better categorization of these cancers by defining specific patient groups, thus allowing for more tailored surgical management and adjuvant treatment. The data and analyses on molecular and histological classification developed in the 2021 guidelines from the European Societies of Gynecologic Oncology (ESGO), Radiation Therapy and Oncology (ESTRO), and Anatomical Pathology (ESP) have been utilized to develop the new 2023 FIGO classification for endometrial cancer. We are witnessing an evolution of the FIGO classification, shifting from a purely anatomical classification to a risk-based classification. It is important in pathology reports to specify the histological type of the tumor, the grade for endometrioid tumors, the presence or absence of lymphovascular space invasion, and the extent of the tumor (myometrial invasion, involvement of the serosa, cervix, vagina, adnexa, or neighboring organs). These essential points are included in the 2023 FIGO classification and will enable precise staging of the tumor. This article aims to clarify and simplify the classification of patients according to the new 2023 FIGO classification for endometrial cancer.
自2009年国际妇产科联盟(FIGO)的上一次分类以来,众多研究和建议推动了子宫内膜癌管理的改善。分子分类(包括POLE、错配修复(MMR)和P53状态)的引入,通过定义特定患者群体,实现了对这些癌症更好的分类,从而能够进行更具针对性的手术管理和辅助治疗。欧洲妇科肿瘤学会(ESGO)、放射治疗与肿瘤学会(ESTRO)和解剖病理学学会(ESP)在2021年指南中开展的关于分子和组织学分类的数据及分析,已被用于制定2023年FIGO子宫内膜癌新分类。我们正在见证FIGO分类的演变,从单纯的解剖学分类转向基于风险的分类。在病理报告中明确肿瘤的组织学类型、子宫内膜样肿瘤的分级、是否存在淋巴血管间隙浸润以及肿瘤范围(肌层浸润、浆膜、宫颈、阴道、附件或邻近器官受累情况)非常重要。这些要点已纳入2023年FIGO分类,将有助于实现肿瘤的精确分期。本文旨在根据2023年FIGO子宫内膜癌新分类,阐明并简化患者分类。