Staging Uterine Cancer and Endometrial Cancer

The main goal of staging uterine cancer is to determine the extent of the disease. Endometrial cancer and uterine cancer also are graded to aid in the evaluation.

Factors used to stage the disease include the depth of the tumor, whether the tumor has spread to the cervix and other nearby organs, the cytology of the cancer (cellular make-up and activity), whether it has metastasized to the lymph nodes, and the extent to which it has spread to other parts of the body.

Endometrial cancer in patients who are unable to undergo surgical evaluation, is staged using an older, clinical staging system.

Surgical Stages For Endometrial Cancer

Stage I The tumor is confined to the uterus. Stage I is divided into stages IA, IB, and IC.
Stage IA The tumor is limited to the endometrium (the lining of the uterus).
Stage IB The tumor invades the inner half of the myometrium (the muscular tissue that is found just beneath the endometrium).
Stage IC The tumor invades has spread into the outer half of the myometrium.
Stage II The tumor has spread from the uterus to the cervix (the lower part of the uterus), but has not spread outside the uterus. Stage II is divided into stages IIA and IIB.
Stage IIA Cervical extension is limited to the endocervical glands (glands in the inner lining of the uterus, where the cervix meets the uterus).
Stage IIB Tumor invades the cervical stroma (the supporting connective tissue of the cervix).
Stage III The cancer has spread beyond the uterus and cervix, but not beyond the pelvis. Stage III is divided into stages IIIA, IIIB, and IIIC.
Stage IIIA The tumor has spread to one or more of the following: the outermost layer of the uterus (uterine serosa), the tissue just beyond the uterus (e.g., adnexa—tissues on either side of the uterus), or the peritoneum (membrane surrounding the abdominal cavity).
Stage IIIB Cancer has spread beyond the uterus and cervix, into the vagina.
Stage IIIC The tumor has spread to lymph nodes near the uterus.
Stage IV Cancer has spread beyond the pelvis. Stage IV is divided into stages IVA and IVB.
Stage IVA Tumor has spread to the bladder and/or wall of the bowel.
Stage IVB Cancer has spread to other parts of the body beyond the pelvis, including lymph nodes in the abdomen and/or groin (called distant metastasis).

FIGO Clinical Staging System

Stage 1 The tumor is limited to the uterine body.
Stage 1A Uterine cavity measures 8 cm or less.
Stage 1B Uterine cavity measures greater than 8 cm.
Stage 2 Tumor extends to the uterine cervix.
Stage 3 Tumor has spread to the adjacent pelvic structures.
Stage 4 Bulky pelvic disease or distant spread.
Stage 4A The tumor invades the mucosa of the bladder or rectum.
Stage 4B Distant metastasis is present.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 15 Aug 1999

Last Modified: 24 May 2011