ArticleJournal of gynecologic oncology2026
Clinical outcomes and adjuvant therapy in stage IC endometrial cancer under the revised 2023 FIGO staging system: a multicenter analysis.
Article in Journal of gynecologic oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe revised 2023 International Federation of Gynecology and Obstetrics (FIGO) staging scheme for endometrial cancers (ECs) classifies tumors without myometrial invasion and with a non-aggressive histology as stage IA1, while those with aggressive histology are upgraded to stage IC. However, clinical guidelines lack evidence regarding prognostic and treatment strategies. This study evaluated survival outcomes of stage IC ECs and the impact of adjuvant therapy.
methodsData from the Chinese cohort and the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed. Overall survival (OS) and recurrence-free survival (RFS) were assessed using Kaplan-Meier curves and Cox-regression methods to assess treatment outcomes and identify risk factors.
resultsPatients with stage IC had poorer 5-year-RFS (China: IA1 vs. IC, 97.5% vs 92.84%) and OS (SEER: IA1 vs. IC, 95.95% vs. 86.25%) than stage IA1. Despite 34/44 (77.3%) patients from China and 483/886 (54.5%) patients from SEER cohort received adjuvant therapy, no RFS (Chinese cohort, p=0.489) or OS (SEER cohort, p=0.560) improvement was observed, and neither chemotherapy, radiotherapy, nor their combination improved prognosis than no adjuvant therapy for ECs in stage IC ECs. Non-endometrioid histology was the only independent risk factor for worse OS (hazard ratio=1.672, 95% confidence interval=1.009-2.77). Subgroup analyses revealed no survival benefit from adjuvant treatment in endometrioid (p=0.943) or non-endometrioid (p=0.884) tumors.
conclusionIn ECs without myometrial invasion, stage IC has poorer prognosis than IA1. However, adjuvant therapy did not improve survival, regardless of histologic subtype.
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