Does the FIGO 2009 endometrial cancer staging system more accurately correlate with clinical outcome in different histologies? Revised staging, endometrial cancer, histology

Brandi Page, Lisa Pappas, Ellen Ware Cooke, David K. Gaffney

Research output: Contribution to journalArticle

Abstract

Objective: In 2009, the International Federation of Gynecology and Obstetrics (FIGO) staging system was revised for endometrial cancers. Different histologies were examined in a large population database. The FIGO 1988 and 2009 staging systems were compared for stage at presentation, differences in patient populations, and disease-specific survival (DSS). Methods/Materials: A total of 10,839 cases from 1998 to 2006 were analyzed from the Surveillance, Epidemiology, and End Results (SEER) Program. Examined histologies included 1377 cases of clear cell carcinoma (CC), 2304 cases of uterine papillary serous carcinoma (PS), 755 cases of carcinosarcoma (CS), and 6403 cases of grade 3 endometrial adenocarcinoma (G3A). The median follow-up was 26 months. For each stage and histology, DSS for patient characteristics was examined. Results: Of the 10,839 women with CC, PS, CS, and G3A had a median age of 67 years. White, black, and other ethnicities composed 87.5%, 12%, and 7% of this group, respectively. A higher percentage of non-G3A histology (CS, PS, and CC) was found in 58% of black women versus 39% of white women. The best to worst 5-year DSS was G3A (76.2%), CC (68.8%), PS (59%), and CS (53.4%). Patients with FIGO IIIC2 disease had inferior survival outcomes in CC (P = 0.0079) and G3A (P = 0.047) compared with FIGO IIIC1 disease, whereas DSS was not significantly different for CS and PS between stages IIIC1 and IIIC2. Conclusions: These findings describe differences in the DSS of various aggressive histologies of EC, with poorer DSS in PS, CC, or CS histologies. Analysis demonstrated the usefulness of the new FIGO staging for DSS prediction between stages IIIC1 and IIIC2 for CC and G3A, and 2 divisions for stage I rather than three.

Original languageEnglish (US)
Pages (from-to)593-598
Number of pages6
JournalInternational Journal of Gynecological Cancer
Volume22
Issue number4
DOIs
StatePublished - May 2012
Externally publishedYes

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Neoplasm Staging
Endometrial Neoplasms
Gynecology
Obstetrics
Carcinosarcoma
Histology
Papillary Carcinoma
Adenocarcinoma
Survival
Carcinoma
SEER Program
Population
Databases

Keywords

  • Cancer
  • Carcinoma
  • Carcinosarcoma
  • Clear cell carcinoma
  • Endometrial cancer
  • FIGO 2009 staging
  • Grade 3 adenocarcinoma
  • High risk
  • Histology
  • Uterine
  • Uterine papillary serous carcinoma
  • Uterus

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

@article{6eacac0d1dce452e8eed5bcf896e6231,
title = "Does the FIGO 2009 endometrial cancer staging system more accurately correlate with clinical outcome in different histologies?: Revised staging, endometrial cancer, histology",
abstract = "Objective: In 2009, the International Federation of Gynecology and Obstetrics (FIGO) staging system was revised for endometrial cancers. Different histologies were examined in a large population database. The FIGO 1988 and 2009 staging systems were compared for stage at presentation, differences in patient populations, and disease-specific survival (DSS). Methods/Materials: A total of 10,839 cases from 1998 to 2006 were analyzed from the Surveillance, Epidemiology, and End Results (SEER) Program. Examined histologies included 1377 cases of clear cell carcinoma (CC), 2304 cases of uterine papillary serous carcinoma (PS), 755 cases of carcinosarcoma (CS), and 6403 cases of grade 3 endometrial adenocarcinoma (G3A). The median follow-up was 26 months. For each stage and histology, DSS for patient characteristics was examined. Results: Of the 10,839 women with CC, PS, CS, and G3A had a median age of 67 years. White, black, and other ethnicities composed 87.5{\%}, 12{\%}, and 7{\%} of this group, respectively. A higher percentage of non-G3A histology (CS, PS, and CC) was found in 58{\%} of black women versus 39{\%} of white women. The best to worst 5-year DSS was G3A (76.2{\%}), CC (68.8{\%}), PS (59{\%}), and CS (53.4{\%}). Patients with FIGO IIIC2 disease had inferior survival outcomes in CC (P = 0.0079) and G3A (P = 0.047) compared with FIGO IIIC1 disease, whereas DSS was not significantly different for CS and PS between stages IIIC1 and IIIC2. Conclusions: These findings describe differences in the DSS of various aggressive histologies of EC, with poorer DSS in PS, CC, or CS histologies. Analysis demonstrated the usefulness of the new FIGO staging for DSS prediction between stages IIIC1 and IIIC2 for CC and G3A, and 2 divisions for stage I rather than three.",
keywords = "Cancer, Carcinoma, Carcinosarcoma, Clear cell carcinoma, Endometrial cancer, FIGO 2009 staging, Grade 3 adenocarcinoma, High risk, Histology, Uterine, Uterine papillary serous carcinoma, Uterus",
author = "Brandi Page and Lisa Pappas and Cooke, {Ellen Ware} and Gaffney, {David K.}",
year = "2012",
month = "5",
doi = "10.1097/IGC.0b013e3182412ebd",
language = "English (US)",
volume = "22",
pages = "593--598",
journal = "International Journal of Gynecological Cancer",
issn = "1048-891X",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Does the FIGO 2009 endometrial cancer staging system more accurately correlate with clinical outcome in different histologies?

T2 - Revised staging, endometrial cancer, histology

AU - Page, Brandi

AU - Pappas, Lisa

AU - Cooke, Ellen Ware

AU - Gaffney, David K.

PY - 2012/5

Y1 - 2012/5

N2 - Objective: In 2009, the International Federation of Gynecology and Obstetrics (FIGO) staging system was revised for endometrial cancers. Different histologies were examined in a large population database. The FIGO 1988 and 2009 staging systems were compared for stage at presentation, differences in patient populations, and disease-specific survival (DSS). Methods/Materials: A total of 10,839 cases from 1998 to 2006 were analyzed from the Surveillance, Epidemiology, and End Results (SEER) Program. Examined histologies included 1377 cases of clear cell carcinoma (CC), 2304 cases of uterine papillary serous carcinoma (PS), 755 cases of carcinosarcoma (CS), and 6403 cases of grade 3 endometrial adenocarcinoma (G3A). The median follow-up was 26 months. For each stage and histology, DSS for patient characteristics was examined. Results: Of the 10,839 women with CC, PS, CS, and G3A had a median age of 67 years. White, black, and other ethnicities composed 87.5%, 12%, and 7% of this group, respectively. A higher percentage of non-G3A histology (CS, PS, and CC) was found in 58% of black women versus 39% of white women. The best to worst 5-year DSS was G3A (76.2%), CC (68.8%), PS (59%), and CS (53.4%). Patients with FIGO IIIC2 disease had inferior survival outcomes in CC (P = 0.0079) and G3A (P = 0.047) compared with FIGO IIIC1 disease, whereas DSS was not significantly different for CS and PS between stages IIIC1 and IIIC2. Conclusions: These findings describe differences in the DSS of various aggressive histologies of EC, with poorer DSS in PS, CC, or CS histologies. Analysis demonstrated the usefulness of the new FIGO staging for DSS prediction between stages IIIC1 and IIIC2 for CC and G3A, and 2 divisions for stage I rather than three.

AB - Objective: In 2009, the International Federation of Gynecology and Obstetrics (FIGO) staging system was revised for endometrial cancers. Different histologies were examined in a large population database. The FIGO 1988 and 2009 staging systems were compared for stage at presentation, differences in patient populations, and disease-specific survival (DSS). Methods/Materials: A total of 10,839 cases from 1998 to 2006 were analyzed from the Surveillance, Epidemiology, and End Results (SEER) Program. Examined histologies included 1377 cases of clear cell carcinoma (CC), 2304 cases of uterine papillary serous carcinoma (PS), 755 cases of carcinosarcoma (CS), and 6403 cases of grade 3 endometrial adenocarcinoma (G3A). The median follow-up was 26 months. For each stage and histology, DSS for patient characteristics was examined. Results: Of the 10,839 women with CC, PS, CS, and G3A had a median age of 67 years. White, black, and other ethnicities composed 87.5%, 12%, and 7% of this group, respectively. A higher percentage of non-G3A histology (CS, PS, and CC) was found in 58% of black women versus 39% of white women. The best to worst 5-year DSS was G3A (76.2%), CC (68.8%), PS (59%), and CS (53.4%). Patients with FIGO IIIC2 disease had inferior survival outcomes in CC (P = 0.0079) and G3A (P = 0.047) compared with FIGO IIIC1 disease, whereas DSS was not significantly different for CS and PS between stages IIIC1 and IIIC2. Conclusions: These findings describe differences in the DSS of various aggressive histologies of EC, with poorer DSS in PS, CC, or CS histologies. Analysis demonstrated the usefulness of the new FIGO staging for DSS prediction between stages IIIC1 and IIIC2 for CC and G3A, and 2 divisions for stage I rather than three.

KW - Cancer

KW - Carcinoma

KW - Carcinosarcoma

KW - Clear cell carcinoma

KW - Endometrial cancer

KW - FIGO 2009 staging

KW - Grade 3 adenocarcinoma

KW - High risk

KW - Histology

KW - Uterine

KW - Uterine papillary serous carcinoma

KW - Uterus

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U2 - 10.1097/IGC.0b013e3182412ebd

DO - 10.1097/IGC.0b013e3182412ebd

M3 - Article

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AN - SCOPUS:84861485091

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JO - International Journal of Gynecological Cancer

JF - International Journal of Gynecological Cancer

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