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) |
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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) |
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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 |