A digital application increases the accuracy and reduces the time required to determine the stage of endometrial cancer according to the 2023 FIGO staging system

Abstract

Objective

The 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system for endometrial cancer has significantly increased the complexity of stage determination. We developed a digital application, the Endometrial Cancer Staging (ECAS) application, to assist in determining the endometrial cancer stage. This study aimed to assess whether ECAS can increase the accuracy and reduce the time required for staging endometrial cancer compared to conventional lookup methods.

Materials and methods

This self-controlled, paired study was conducted at the Taipei Veterans General Hospital. We designed an evaluation test comprising two parts, each with ten pathology reports. Evaluators with different levels of clinical experience were recruited. They utilized the ECAS application and conventional lookup methods to stage endometrial cancer in different parts of the test. The accuracy and time required for stage determination were collected and analyzed.

Results

The ECAS application significantly increased the accuracy (92.1 % vs. 58.1 %, p < 0.001) and reduced the time required (897 s vs. 1152 s, p < 0.001) to determine the stage of endometrial cancer compared to the conventional method. When stratified by specialty, among evaluators without a gynecologic specialty, ECAS showed increased accuracy (90.5 % vs. 52.4 %, p < 0.001) and reduced time (1029 s vs. 1487 s, p < 0.001). For evaluators with a gynecologic specialty, ECAS application increased accuracy (93.3 % vs. 62.6 %, p < 0.001); however, it did not significantly reduce the time required (795 s vs. 890 s, p = 0.098). For complex conditions, ECAS improved the accuracy of stage determination for molecular classification (94.8 % vs. 49.0 %, p < 0.001) and stage IA3 disease (91.7 % vs. 58.3 %, p < 0.001).

Conclusions

The ECAS application increased the accuracy and reduced the time required to determine the stage of endometrial cancer according to the 2023 FIGO staging system.