According to FIGO 2023 staging of endometrial carcinoma, which NEW molecular subtype-based change was incorporated that was NOT present in FIGO 2009?

• A Stage IVA now includes bladder or rectal mucosa invasion
• B Molecular classification (POLE-ultramutated, MMR-deficient, p53-mutant) now modifies staging ✓
• C Stage IC was added for outer half myometrial invasion
• D Cervical stromal invasion was reclassified from Stage II to Stage IIIA

Explanation

The FIGO 2023 revised staging of endometrial carcinoma introduced molecular subtyping (ProMisE/TCGA classification) as a staging modifier for the first time. POLE-ultramutated tumors are upstaged to Stage IA(m) regardless of invasion depth due to excellent prognosis; p53-mutant (serous-like) tumors with no/superficial invasion are classified as Stage IIC given poor prognosis. This integration of molecular pathology into staging was a landmark change from FIGO 2009, which was purely surgical-anatomical.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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