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Aim <p>To evaluate the utility of systemic inflammatory parameters in predicting upstaging according to FIGO 2023 staging in early-stage endometrial cancer (EC), patients initially staged under the FIGO 2009 system.</p> Methods <p>A total of 166 patients diagnosed with stage I EC according to the FIGO 2009 staging system were included. Surgical specimens were re-staged according to the FIGO 2023 criteria, and cases that transitioned to a higher stage category were classified as upstaged. Systemic inflammatory parameters were compared between upstaged and non-upstaged cases.</p> Results <p>Among the included patients, 18% were observed to have upstaging according to FIGO 2023 criteria. The new stages according to the FIGO 2023 staging system for the 121 patients initially staged as IA in FIGO 2009 were as follows: 2.5% were classified as stage IC, 1.7% as stage IIB, and 12.4% as stage IIC. For the 45 patients initially staged as IB in FIGO 2009, 17.7% were classified as stage IIB, and 4.5% as stage IIC. In the comparison between patients with and without upstaging, calculated SIRI median value ((1.3 (0.5–4.8) vs 1.0 (0.4–9.4), <i>p</i> 0.046, respectively) were significantly different. In the ROC analysis, only SIRI reliably predicted upstaging. The optimal cutoff ratio was determined as 1.17, achieving 55% sensitivity and 57% specificity (AUC = 0.616, <i>p</i> = 0.049).</p> Conclusion <p>Eighteen percent of early-stage EC patients initially staged as FIGO 2009 stage I were reclassified to a higher stage under the FIGO 2023 system. SIRI levels were higher in upstaged patients and SIRI may serve as a predictive marker for upstaging.</p>

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Systemic Inflammatory Markers Predict Upstaging in Early-Stage Endometrial Cancer: A FIGO 2023 Reclassification Study

  • 期刊论文

  • 发表日期：

    2025年7月22日

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  • Neslihan Öztürk,
  • Burak Ersak,
  • Hande Nur Öncü,
  • Gökçen Ege,
  • Baran Yeşil,
  • Oğuz Kaan Köksal,
  • Candost Hanedan,
  • Vakkas Korkmaz

摘要

Aim

To evaluate the utility of systemic inflammatory parameters in predicting upstaging according to FIGO 2023 staging in early-stage endometrial cancer (EC), patients initially staged under the FIGO 2009 system.

Methods

A total of 166 patients diagnosed with stage I EC according to the FIGO 2009 staging system were included. Surgical specimens were re-staged according to the FIGO 2023 criteria, and cases that transitioned to a higher stage category were classified as upstaged. Systemic inflammatory parameters were compared between upstaged and non-upstaged cases.

Results

Among the included patients, 18% were observed to have upstaging according to FIGO 2023 criteria. The new stages according to the FIGO 2023 staging system for the 121 patients initially staged as IA in FIGO 2009 were as follows: 2.5% were classified as stage IC, 1.7% as stage IIB, and 12.4% as stage IIC. For the 45 patients initially staged as IB in FIGO 2009, 17.7% were classified as stage IIB, and 4.5% as stage IIC. In the comparison between patients with and without upstaging, calculated SIRI median value ((1.3 (0.5–4.8) vs 1.0 (0.4–9.4), p 0.046, respectively) were significantly different. In the ROC analysis, only SIRI reliably predicted upstaging. The optimal cutoff ratio was determined as 1.17, achieving 55% sensitivity and 57% specificity (AUC = 0.616, p = 0.049).

Conclusion

Eighteen percent of early-stage EC patients initially staged as FIGO 2009 stage I were reclassified to a higher stage under the FIGO 2023 system. SIRI levels were higher in upstaged patients and SIRI may serve as a predictive marker for upstaging.