TNM Classification for Endometrial Cancer

The tumor-node-metastasis (TNM) classification for staging of endometrial cancer is provided below.^{[1, 2, 3]}

Table 1. TNM Classification for Endometrial Cancer (Open Table in a new window)

Primary tumor (T)
TNM	FIGO stages	Surgical-pathologic findings
TX		Primary tumor cannot be assessed
T0		No evidence of primary tumor
Tis*		Carcinoma in situ (preinvasive carcinoma)
T1	I	Tumor confined to corpus uteri
T1a	IA	Tumor limited to endometrium or invades less than one half of the myometrium
T1b	IB	Tumor invades one half or more of the myometrium
T2	II	Tumor invades stromal connective tissue of the cervix but does not extend beyond uterus**
T3a	IIIA	Tumor involves serosa and/or adnexa (direct extension or metastasis)
T3b	IIIB	Vaginal involvement (direct extension or metastasis) or parametrial involvement
	IIIC	Metastases to pelvic and/or para-aortic lymph nodes
	IV	Tumor invades bladder mucosa and/or bowel mucosa, and/or distant metastases
T4	IVA	Tumor invades bladder mucosa and/or bowel mucosa (bullous edema is not sufficient to classify a tumor as T4)
FIGO no longer includes stage 0 (Tis) *Endocervical glandular involvement should only be considered as stage I and no longer as stage II
Regional lymph nodes (N)
TNM	FIGO stages	Surgical-pathologic findings
NX		Regional lymph nodes cannot be assessed
N0		No regional lymph node metastasis
N1	IIIC1	Regional lymph node metastasis to pelvic lymph nodes
N1mi	IIIC1	Regional lymph node metastasis > 0.2 mm but ≤ 2.0 mm in diameter to pelvic lymph nodes
N1a	IIIC1	Regional lymph node metastasis > 2.0 mm in diameter to pelvic lymph nodes
N2	IIIC2	Regional lymph node metastasis to para-aortic lymph nodes, with or without positive pelvic lymph nodes
N2mi	IIIC2	Regional lymph node metastasis > 0.2 mm but ≤ 2.0 mm in diameter to para-aortic lymph nodes, with or without positive pelvic lymph nodes
N2a	IIIC2	Regional lymph node metastasis > 2.0 mm in diameter to para-aortic lymph nodes, with or without positive pelvic lymph nodes
Distant metastasis (M)
TNM	FIGO stages	Surgical-pathologic findings
M0		No distant metastasis
M1	IVB	Distant metastasis (includes metastasis to inguinal lymph nodes, intraperitoneal disease, or lung, liver, or bone metastases; it excludes metastasis to para-aortic lymph nodes, vagina, pelvic serosa, or adnexa)

Prognostic Stage Groups

AJCC Prognostic Stage Groups are provided below.^{[1, 2]}

Table 2. AJCC Prognostic Stage Groups (Open Table in a new window)

Stage	T	N	M
I	T1	N0	M0
IA	T1a	N0	M0
IB	T1b	N0	M0
II	T2	N0	M0
III	T3	N0	M0
IIIA	T3a	N0	M0
IIIB	T3b	N0	M0
IIIC1	T1-T3	N1/N1mi/N1a	M0
IIIC2	T1-T3	N2/N2mi/N2a	M0
IVA	T4	Any N	M0
IVB	Any T	Any N	M1

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Table 1. TNM Classification for Endometrial Cancer

Primary tumor (T)
TNM	FIGO stages	Surgical-pathologic findings
TX		Primary tumor cannot be assessed
T0		No evidence of primary tumor
Tis*		Carcinoma in situ (preinvasive carcinoma)
T1	I	Tumor confined to corpus uteri
T1a	IA	Tumor limited to endometrium or invades less than one half of the myometrium
T1b	IB	Tumor invades one half or more of the myometrium
T2	II	Tumor invades stromal connective tissue of the cervix but does not extend beyond uterus**
T3a	IIIA	Tumor involves serosa and/or adnexa (direct extension or metastasis)
T3b	IIIB	Vaginal involvement (direct extension or metastasis) or parametrial involvement
	IIIC	Metastases to pelvic and/or para-aortic lymph nodes
	IV	Tumor invades bladder mucosa and/or bowel mucosa, and/or distant metastases
T4	IVA	Tumor invades bladder mucosa and/or bowel mucosa (bullous edema is not sufficient to classify a tumor as T4)
FIGO no longer includes stage 0 (Tis) *Endocervical glandular involvement should only be considered as stage I and no longer as stage II
Regional lymph nodes (N)
TNM	FIGO stages	Surgical-pathologic findings
NX		Regional lymph nodes cannot be assessed
N0		No regional lymph node metastasis
N1	IIIC1	Regional lymph node metastasis to pelvic lymph nodes
N1mi	IIIC1	Regional lymph node metastasis > 0.2 mm but ≤ 2.0 mm in diameter to pelvic lymph nodes
N1a	IIIC1	Regional lymph node metastasis > 2.0 mm in diameter to pelvic lymph nodes
N2	IIIC2	Regional lymph node metastasis to para-aortic lymph nodes, with or without positive pelvic lymph nodes
N2mi	IIIC2	Regional lymph node metastasis > 0.2 mm but ≤ 2.0 mm in diameter to para-aortic lymph nodes, with or without positive pelvic lymph nodes
N2a	IIIC2	Regional lymph node metastasis > 2.0 mm in diameter to para-aortic lymph nodes, with or without positive pelvic lymph nodes
Distant metastasis (M)
TNM	FIGO stages	Surgical-pathologic findings
M0		No distant metastasis
M1	IVB	Distant metastasis (includes metastasis to inguinal lymph nodes, intraperitoneal disease, or lung, liver, or bone metastases; it excludes metastasis to para-aortic lymph nodes, vagina, pelvic serosa, or adnexa)