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Endometrial cancer staging

Dr Praveen Jha and Dr Frank Gaillard et al.

Endometrial cancer staging allows appropriate treatment options to be considered and enables greater prognostic accuracy for endometrial cancer.

Staging can be based on the TNM or FIGO system. MR imaging is the modality of choice for staging with CT having relatively low specificty (especially for myometrial invasion ⁵).

Revised 2009 FIGO staging for carcinoma of the endometrium ⁷

stage 0 : carcinoma in situ
stage I : limited to the body of the uterus
- Ia : no or less than half myometrial invasion
- Ib : invasion equal to or more than half of the myometrium
stage II : cervical stromal involvement
stage III : local or regional spread of the tumour
- IIIa : tumour invades the serosa of the body of the uterus and or adenexae
- IIIb : vaginal or parametrial involvement
- IIIc : pelvic or para-aortic lymphadenopathy
  - IIIc1: positive pelvic nodes
  - IIIc2 : positive para-aortic nodes with or without pelvic nodes
stage IV : Involvement of rectum and or bladder mucosa and or distant metastasis
- IVa : bladder or rectal mucosal involvement
- IVb : distant metastases , malignant ascites, peritoneal involvement