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Cancer Staging Systems

Staging of endometrial cancer

Stage grouping

Stage I

Stage I endometrial cancer is carcinoma confined to the corpus uteri.

• Stage IA: tumor limited to endometrium.
• Stage IB: invasion to less than one half of the myometrium.
• Stage IC: invasion to greater than one half of the myometrium.

Stage II

Stage II endometrial cancer involves the corpus and the cervix, but has not extended outside the uterus.

• Stage IIA: endocervical glandular involvement only.
• Stage IIB: cervical stromal invasion.

Stage III

Stage III endometrial cancer extends outside of the uterus but is confined to the true pelvis.

• Stage IIIA: tumor invades serosa and/or adnexa and/or positive peritoneal cytology.
• Stage IIIB: vaginal metastases.
• Stage IIIC: metastases to pelvic and/or para-aortic lymph nodes.

Stage IV

Stage IV endometrial cancer involves the bladder or bowel mucosa or has metastasized to distant sites.

• Stage IVA: tumor invasion of bladder and/or bowel mucosa.
• Stage IVB: distant metastases, including intra-abdominal and/or inguinal lymph nodes.

Endometrial cancer can be grouped with regard to the degree of differentiation of the adenocarcinoma, as follows:

• G1: 5% or less of a nonsquamous or nonmorular solid growth pattern.
• G2: 6% to 50% of a nonsquamous or nonmorular solid growth pattern.
• G3: more than 50% of a nonsquamous or nonmorular solid growth pattern.

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FIGO staging for endometrial cancer

• Stage IA G123: tumor limited to endometrium.
• Stage IB G123: invasion to less than one half the myometrium.
• Stage IC G123: invasion to more than one half the myometrium.
• Stage IIA G123: endocervical glandular involvement only.
• Stage IIB G123: cervical stromal invasion.
• Stage IIIA G123:tumor invades serosa and/or adnexa, and/or positive peritoneal cytology.
• Stage IIIB G123:vaginal metastases.
• Stage IIIC G123:metastases of pelvic and/or para-aortic lymph nodes.
• Stage IVA G123: tumor invasion of bladder and/or bowel mucosa.
• Stage IVB: distant metastases including intra-abdominal and/or inguinal lymph nodes.

References

1. FIGO staging for corpus cancer. Br J Obstet Gynaecol 99(5): 440, 1992.
2. Corpus uteri. In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 5th ed. Philadelphia, Pa: Lippincott-Raven Publishers, 1997, pp 195-200. 

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