Understanding Your Stage of Endometrial Cancer

Stage is the word doctors use to describe where the tumor is and how far the cancer has spread. Doctors use the stage to describe what was found in and around the uterus during surgery. So the stage of endometrial cancer may not be decided until after your uterus is removed.

The most commonly used systems to stage endometrial cancer are the FIGO staging system, developed by the International Federation of Gynecology and Obstetrics, and the AJCC system, developed by the American Joint Committee on Cancer, called TNM staging. The two systems are much the same. The AJCC TNM system was updated in 2010 and is described here:

Stage I. The cancer is only in the body of the uterus. The body is called the corpus. The cancer has not spread to lymph nodes or other parts of the body: 

• Stage IA. The cancer is only in the endometrium, which is the uterine lining, or it has spread less than halfway through the myometrium, which is the muscular outer layer of the uterus. 

• Stage IB. The cancer has spread more than halfway through the myometrium.

Stage II. The cancer has spread from the uterus to the connective tissue in the cervix. The cervix is the lower end of the uterus that connects to the vagina. It has not spread outside the uterus or to lymph nodes or distant parts of the body. 

Stage III. The cancer has spread beyond the uterus. But it is still only in the pelvic area:

• Stage IIIA. The cancer has spread to the outer lining (serosa) of the uterus, or to the fallopian tubes or ovaries. It has not spread to the lymph nodes or distant parts of the body.

• Stage IIIB. The cancer has spread to the vagina or to the tissues surrounding the uterus called the parametrium. It has not spread to the lymph nodes or distant parts of the body.

• Stage IIIC. The cancer has spread to the lymph nodes near the uterus. It may also have spread to some nearby tissues but has not invaded the bladder or rectum. 

Stage IV. The cancer has spread beyond the pelvic area:

• Stage IVA. The cancer has spread to the mucosa or inner lining of the rectum or bladder. It may also have spread to nearby lymph nodes, but not to distant parts of the body. 

• Stage IVB. The cancer has spread to organs away from the uterus, such as the lungs or bones. It may also have spread to lymph nodes.

Cancer that comes back after it has been treated is said to have recurred.