A 58-year-old woman is diagnosed with endometrial carcinoma: endometrioid grade 2, invasion to outer half of myometrium, extensive lymphovascular space invasion (LVSI), pelvic lymph nodes negative on sentinel lymph node biopsy. Under FIGO 2023 staging, the presence of extensive LVSI in this scenario upgrades the stage to:
- A Stage IB (outer half invasion with focal LVSI)
- B Stage II (extensive LVSI upgrades to Stage II in FIGO 2023) ✓
- C Stage IIIC1 (due to lymph node positivity)
- D Stage IA (LVSI does not affect staging)
Correct answer: B. Stage II (extensive LVSI upgrades to Stage II in FIGO 2023)
Explanation
FIGO 2023 endometrial carcinoma staging introduced a new category: tumours with substantial/extensive LVSI are upgraded to Stage II regardless of cervical stromal involvement or node status. This is a key change from FIGO 2009, where Stage II required cervical stromal invasion. Focal LVSI remains Stage IB. Negative pelvic nodes exclude Stage IIIC1.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.