FIGO staging updates for endometrial cancer

pik3r1

Just came across this news. The FIGO stages now have a bit more detail in the breakdown. I hope this will help to improve treatment for anyone diagnosed in the future.

• Inclusion of the various histological types, tumour patterns, and molecular classification to better reflect the improved understanding of the complex nature of the several types of endometrial carcinoma and their underlying biologic behaviour.

https://www.figo.org/news/figo-staging-endometrial-cancer-2023

cmb

Thank you for sharing this link. Hopefully these more specific staging categories and the focus on molecular classification will lead to better treatment recommendations.

Prayer2023

Can anyone please tell me what this addendum in my pathology report means… Immunohistochemical stains for the mismatch repair proteins MLH1, MSH2, MSH6 and PMS2 were performed (with appropriately positive and negative controls). The tumor cells demonstrate retained nuclear staining for all four proteins, indicating the tumor is MMR proficient (pMMR) and likely microsatellite stable.

MLH1 - EXPRESSED

MSH2 - EXPRESSED

MSH6 - EXPRESSED

PMS2 - EXPRESSED

P53 immunostain (with appropriately reactive control) shows wild-type P 53 expression. 

The Ki-67 mitotic index is estimated at 50%.

cmb

Microsatellite stable means that it is unlikely that the cancer is related to a hereditary condition like Lynch Syndrome (which I have). This is good news since it reduces the chances of developing certain cancers. Testing for Lynch Syndrome was the only genomic/genetic test I had back in 2016.

Since then, research has shown that other markers like P53 can impact treatment approaches. I’ve only heard of the Ki-67 index in relation to breast cancer, but perhaps current research is showing that this is also a useful indicator in uterine cancer.  Others who have been diagnosed and tested more recently than I was may be able to share more information. The report that was linked above does discuss P53 and it's potential impact on treatment.

But even when markers are present that lead to, or suggest, a more difficult road to recovery, it’s important to remember that we are all unique. I was diagnosed with a later stage, very aggressive form of uterine cancer that typically has a high recurrence rate or higher mortality within the first five years than other cancer types. I’m still here and without a recurrence over six years later. And that is without the new treatments like immunotherapy that are available today. 

Prayer2023

Thank you for your response! A few minutes ago I received new pathology report from my oncologists office stating that I have grade 3, not grade 1 endometrial cancer. It was just two weeks ago that the initial report stated I have grade 1. I’m so scared and I don’t have my first visit with my oncologist until July17th. I have tried to get the appointment moved. No luck yet.

MoeKay

https://csn.cancer.org/discussion/comment/1706912#Comment_1706912

If I were you, I would request a second pathology review from another institution to confirm the grade of your tumor. While it's possible to go from a grade 1 on biopsy to a grade 3 on pathological review of the hysterectomy specimen, it's my understanding that such an occurrence is quite rare. When I was diagnosed, the results of my endometrial biopsy stated that the cells sampled were grade 1 to grade 2 adenocarcinoma. My final pathology report found that my tumor was a grade 2. I had all the slides from my hysterectomy sent to the Pathology Department at another hospital for confirmation of all of the pathological findings.

Best of luck.

NoTimeForCancer

I know it is all overwhelming but this tells me you had genetic testing, which is great. Please see if you are working with a gynecologic oncologist. There are treatments now that respond based on pMMR or dMMR (which is mismatch repair deficient).

Try to take a breath, this is step by step journey and lots of good warriors and their families are here to support.