新的子宮內膜癌的分期是否較好？

Is it better to use the new staging system for endometrial cancer?

子宮內膜癌的分期在2009年的國際婦產科學會（FIGO: French Federation Internationale de Gynecologie et d'Obstetrique）做了一個大的改變，相對於前一版1988年的子宮內膜癌的分期系統已經超過十年。兩個系統之間最大的差別，在於強調I期上下的不同、II期的子宮頸表面侵犯不再在歸類為二期、腹水中有無癌細胞的存在的已不再列入分期、III期中將子宮頸旁結締組織的侵犯列入以及將骨盆腔與附主動脈旁的淋巴結轉移特別的分開。到底這些轉變，對於我們臨床上的治療是否有影響？本文就針對台北榮民總醫院的資料做一些說明。

International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer (EC) has been revised in 2009. The main changes between the 1988 and 2009 FIGO staging systems for endometrial cancers are: (1) the 1988 FIGO IA and IB are combined into the 2009 FIGO IA, and the 1988 FIGO IC is now the 2009 FIGO IB; (2) stage II no longer has a subset A and B, and endocervical glandular invasion is considered as stage I; (3) positive cytology no longer is part of stage III; (4) parametrial invasion is also classified as 2009FIGO IIIB; and (5) pelvic and para-aortic lymph node invasion is classified as IIIC, based on the poor prognosis. It is interesting to know the influence after this change when we deal with patients with endometrial cancers. Based on the results from Taipei Veterans General Hospital, we would like to share our experience on this issue.