staging of endometrial cancer
Last reviewed 01/2018
Endometrium carcinoma is generally staged according to the International Federation of Gynecology and Obstetrics (FIGO)
Revised (2009) FIGO staging of endometrial cancer:
- stage I -confined to the corpus uteri
- I A - no myometrial invasion or less than half
- I B - invasion equal to or more than half the myometrium
- stage II - tumour invades cervical stroma but does not extend beyond uterus
- stage III - local and/or regional spread of the tumour
- III A - tumour invades serosa of corpus uteri and/or adnexae
- III B - vaginal and/or parametrial involvement
- III C - metastases to pelvic and/or para-aortic lymph nodes
- III C1 - positive pelvic nodes
- III C2 - positive para-aortic lymph nodes with or without positive pelvic
- stage IV – tumour invades bladder and/or bowel mucosa and/or distant metastases
- IVA - tumour invasion of bladder and/or bowel mucosa
- IV B - distant metastases, including intra-abdominal metastases and/or inguinal lymph nodes
Furthermore cases of carcinoma of the corpus should be grouped with regard to the degree of differentiation of the adenocarcinoma as follows:
- G1: <5% of a nonsquamous or nonmorular solid growth pattern
- G2: 6%–50% of a nonsquamous or nonmorular solid growth pattern
- G3: >50% of a nonsquamous or nonmorular solid growth pattern (2)
Note:
- notable nuclear atypia (pleomorphism and prominent nucleoli), inappropriate for the architectural grade, raises the grade of a Grade 1 or Grade 2 tumor by 1
- in serous and clear cell adenocarcinomas, nuclear grading takes precedent. Most authors consider serous and clear cell carcinomas high grade by definition
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