Endometrial Cancer Staging

Updated: Apr 08, 2022
  • Author: William T Creasman, MD; Chief Editor: Yukio Sonoda, MD  more...
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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