Education Resources

Endometrial Cancer Staging

If uterine cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. The stage is based on whether the cancer has invaded nearby tissues or spread to other parts of the body.

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if uterine cancer spreads to the lung, the cancer cells in the lung are actually uterine cancer cells. The disease is metastatic uterine cancer, not lung cancer. It’s treated as uterine cancer, not as lung cancer. Doctors sometimes call the new tumor a “distant” disease.

To learn whether uterine cancer has spread, your doctor may order one or more tests:

  • Chest x-ray

    An x-ray of the chest can show a tumor in the lung.

  • CT Scan

    This cross-sectional view of the body can help identify areas where cancer has spread.

  • MRI

    A large machine with a strong magnet linked to a computer is used to make detailed pictures of your uterus and lymph nodes.

  • PET Scan

    This test is used to identify cancer in other areas of the body, sometimes before the human eye can detect it. A very small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is used. Malignant tumor cells show up brighter in the picture because they are more active and consume more glucose than normal cells.

In most cases, surgery is needed to learn the stage of uterine cancer. The surgeon removes the uterus and may take tissue samples from the pelvis and abdomen. They may also take some nearby lymph nodes for testing. After the uterus is removed, it is checked to see how deeply the tumor has grown. Also, the other tissue samples are checked for cancer cells.

Endometrial Cancer Stages

Doctors assign the stage of endometrial cancer using the FIGO system. The stages of uterine cancer are as follows:

Stage I Endometrial Cancer

Cancer is found in the uterus only.

  • Stage IA: The cancer is found only in the endometrium or less than one-half of the myometrium.

  • Stage IB: The tumor has spread to one-half or more of the myometrium.

Stage II Endometrial Cancer

Cancer has spread into connective tissue of the cervix, but has not spread outside the uterus.

Stage III Endometrial Cancer

Cancer has spread beyond the uterus and cervix, but has not spread beyond the pelvis.

  • Stage IIIA: The cancer has spread to the serosa of the uterus and/or the tissue of the fallopian tubes and ovaries but not to other parts of the body.

  • Stage IIIB: The tumor has spread to the vagina or to the tissue immediately next to the uterus called the parametrium.

  • Stage IIIC1: The cancer has spread to the regional pelvic lymph nodes. Lymph nodes are small, bean-shaped organs that help fight infection.

  • Stage IIIC2: The cancer has spread to the para-aortic lymph nodes with or without spread to the regional pelvic lymph nodes.

Stage IV Endometrial Cancer

Cancer has spread beyond the pelvis.

  • Stage IVA: The cancer has spread to the mucosa of the rectum or bladder.

  • Stage IVB: The cancer has spread to lymph nodes in the groin area, and/or it has spread to distant organs, such as the bones or lungs.

Endometrial Cancer Grades

If cancer is found, the pathologist studies tissue samples from the uterus under a microscope to learn the grade of the tumor. The grade tells how much the tumor tissue differs from normal uterine tissue. If the cancer appears similar to healthy tissue and has different cell groupings, it is called "differentiated" or a "low-grade tumor." If it looks very different from healthy tissue, it is called "poorly differentiated" or a "high-grade tumor."

Tumors with higher grades tend to grow faster than those with lower grades. Tumors with higher grades are also more likely to spread. Doctors use tumor grade along with other factors to suggest treatment options. In general, the slower the growth, the better the prognosis.

The letter "G" is used to define a grade for uterine cancer.

GX: The grade cannot be evaluated.

G1: The cells are well differentiated.

G2: The cells are moderately differentiated.

G3: The cells are poorly differentiated.

The biomarker testing, along with finalizing the stage and grade of endometrial cancer, will impact the types of treatments, other than surgery, that are most likely to work best.

Find a Gynecologic Cancer Specialist Near You

The comprehensive approach offered by our gynecologic cancer team at Affiliated Oncologists combines the most advanced treatments with education and support services. Our oncologists specialize in women’s cancers and are ready to talk to you about your diagnosis and personalized endometrial cancer treatment options.

Our gynecologic cancer centers are located throughout South Chicago, including Downers Grove and Oak Lawn, IL.