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:
- Lu KH, Broaddus RR. Endometrial Cancer. N Engl J Med. 2020 Nov 19;383(21):2053-2064. [Medline]
- 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.
