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Unifying Concepts

Staging Systems for Endometrial Cancer

Staging is performed with the use of the International Federation of Gynecology and Obstetrics (FIGO) system and the tumor–node–metastasis (TNM) system.

Staging Systems for Endometrial Cancer

Primary Tumor (T)
TNM system,
T category
FIGO
system
T criteria
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 I Tumor confined to corpus uteri, including endocervical glandular involvement
T1a IA Tumor limited to the endometrium or invading less than half of the myometrium
T1b IB Tumor invading one half or more of the myometrium
T2 II Tumor invading the stromal connective tissue of the cervix but not extending beyond the uterus
Does not include endocervical glandular involvement
T3 III Tumor involving serosa, adnexa, vagina, or parametrium
T3a IIIA Tumor involving the serosa, adnexa, or both (direct extension or metastasis)
T3b IIIB Vaginal involvement (direct extension or metastasis) or parametrial involvement
T4 IV Tumor invading the bladder mucosa, bowel mucosa, or both
Bullous edema is not sufficient to classify a tumor as T4
Regional Lymph Nodes (N)
TNM system,
N category
FIGO
system
N criteria
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N0(i+) Isolated tumor cells in regional lymph node, ≤0.2 mm in diameter
N1mi IIIC1 Regional lymph node micrometastasis (>0.2 mm to 2.0 mm in diameter) to pelvic lymph nodes
N1 IIIC1 Regional lymph node macrometastasis (>2.0 mm in diameter) to pelvic lymph nodes
N2mi IIIC2 Regional lymph node micrometastasis (>0.2 mm to 2.0 mm in diameter) to paraaortic lymph nodes, with or without positive pelvic lymph nodes
N2 IIIC2 Regional lymph node macrometastasis (>2.0 mm in diameter) to paraaortic lymph nodes, with or without positive pelvic lymph nodes
Distant Metastasis (M)
TNM system,
M category
FIGO
system
M criteria
cM0 No distant metastasis on clinical (c) assessment
cM1 IVB Distant metastasis (includes metastasis to inguinal lymph nodes, lung, liver, or bone or intraperitoneal disease)
Also includes metastasis to pelvic or paraaortic lymph nodes, vagina, uterine serosa, or adnexa
pM1 IVB Distant metastasis (includes metastasis to inguinal lymph nodes, liver, or bone or intraperitoneal disease) microscopically confirmed on pathological (p) assessment
Excludes metastasis to pelvic or paraaortic lymph nodes, vagina, uterine serosa, or adnexa

 

 

References:

  1. Lu KH, Broaddus RR. Endometrial Cancer. N Engl J Med. 2020 Nov 19;383(21):2053-2064. [Medline]
  2. McCluggage WG. Pathologic Staging of Endometrial Carcinomas: Selected Areas of Difficulty. Adv Anat Pathol. 2018 Mar;25(2):71-84. [Medline]

 

Created Jun 18, 2021.

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