子宫内膜癌的FIGO分期:2023年
Jonathan S Berek1, Xavier Matias-Guiu2, Carien Creutzberg3
1Stanford University School of Medicine, Stanford Women's Cancer Center, Stanford Cancer Institute, Stanford, CA, USA. jberek@stanford.edu.
Journal of gynecologic oncology
|August 18, 2023
概括
2023年FIGO对子宫内膜癌的分期结合了组织学,瘤模式和分子分类,以提高预后准确度. 这个更新的系统增强了治疗指导和未来的数据收集,以获得更好的患者结果.
科学领域:
- 妇科瘤学 妇科瘤学
- 癌症的分期 癌症的分期
- 分子病理学分子病理学
背景情况:
- 自2009年FIGO最后一次阶段更新以来,在了解子宫内膜癌的病理和分子特征方面取得了重大进展.
- 增加了各种组织学类型的结果和生物行为数据的可用性.
- 加快分子和遗传发现,包括癌症基因组图谱 (TCGA) 数据,澄清子宫内膜癌的多样性和预后.
研究的目的:
- 重新定义子宫内膜癌的预后组.
- 为更精确的手术,辐射和全身治疗建议引入子阶段.
- 将分子和组织学分类整合到一个精致的分期系统中.
主要方法:
- 由专门的FIGO小组委员会审查关于子宫内膜癌治疗,预后和生存的新证据和已确定的证据.
- 利用ESGO/ESTRO/ESP分子和组织学分类指南中的数据和分析.
- 根据组织学类型,肌肉膜侵袭,淋巴血管空间侵袭 (LVSI),宫层干涉,附/子宫血清透,转移和分子亚型 (POLEmut,MMRd,NSMP,p53abn) 定义的亚阶.
主要成果:
- 2023年的FIGO分期包括组织学类型,瘤模式和分子分类 (例如,POLEmut,MMRd,p53abn).
- 分阶段改进了阶段内的风险分层 (例如,IA2-IA3,IB,IC;IIA-IIC;IIIA-IIIC;IVA-IVC).
- 分子分类可以导致升级或降级 (例如,IICm_p53abn,IAm_POLEmut).
结论:
- 更新的2023年子宫内膜癌分期系统更好地反映了疾病的复杂性质和生物行为.
- 分子和组织学数据的整合为治疗建议提供了更多基于证据的背景.
- 修订后的分期有助于在未来更精细地收集结果和生存数据.
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