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Endometrial cancer staging means finding out how far endometrial cancer has spread in your body. Physicians group endometrial cancer into stages I (1) through IV (4), with stage I being the least advanced and stage IV being the most advanced.
When your Fred Hutch Cancer Center team designs your treatment plan, they will take into account the stage of your cancer along with many other factors. Endometrial cancer staging is an important part of choosing which treatments are right for you.
Endometrial Cancer Care Tailored to You
You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.
Referrals are required for new patients. Please request your primary care provider or specialist fax all relevant medical information to the fax number listed below.
- Phone: 206.598.8300
- Fax: 206.598.3590
How Endometrial Cancer Stages Are Determined
The stage of endometrial cancer depends on whether the cancer has spread:
- Outside the uterus
- Beyond the pelvic area or to tissues in the abdomen
- To any lymph nodes
- To other organs, like your bladder, or other parts of your body, such as your bones
It also depends on how abnormal the cells look and how likely the cancer is to grow and spread (how aggressive it is).
Endometrial Cancer Stages
The most common staging system for gynecological cancers is the International Federation of Gynecology and Obstetrics (FIGO) system. This is the system that gynecologic oncologists at Fred Hutch use.
Stage I (1)
Cancer is only inside the uterus, or in the uterus and ovary for non-aggressive types. It hasn’t spread to nearby lymph nodes or distant parts of the body.
- Stage IA1: Cancer is only in the endometrium.
- Stage IA2: The cancer is a non-aggressive type. It has gone less than halfway through the muscle of the uterus. There are no tumor cells around nearby lymph or blood vessels, or there are some, but only close to the tumor (focal lymphovascular space involvement, LVSI).
- Stage IA3: The cancer is non-aggressive and only in the uterus and ovary.
- Stage IB: The cancer is non-aggressive. It has gone more than halfway through the muscle of the uterus but not outside the body of the uterus. There’s no LVSI or it’s only focal.
- Stage IC: The cancer is aggressive and is only in the endometrium.
Stage II (2)
Cancer has spread to the supporting connective tissue (stroma) of the cervix, or there is substantial LVSI, or it’s an aggressive type and has gone into the muscle of the uterus. It hasn’t spread to nearby lymph nodes or distant parts of the body.
- Stage IIA: The cancer is non-aggressive and is in the cervical stroma.
- Stage IIB: The cancer is non-aggressive, and there’s substantial LVSI.
- Stage IIC: The cancer is aggressive, and it’s in the muscle of the uterus.
Stage III (3)
The cancer is outside the uterus but not in the inner lining of the rectum or bladder.
- Stage IIIA1: Cancer has spread to the ovary or fallopian tube (and it’s not stage IA1). It hasn’t spread to nearby lymph nodes or distant parts of the body.
- Stage IIIA2: Cancer has spread to the outer surface of the uterus (serosa). It hasn’t spread to nearby lymph nodes or distant parts of the body.
- Stage IIIB1: Cancer has spread to the vagina or tissues around the uterus (parametrium). It hasn’t spread to nearby lymph nodes or distant parts of the body.
- Stage IIIB2: Cancer has spread to the lining of the pelvic area (peritoneum). It hasn’t spread to nearby lymph nodes or distant parts of the body.
- Stage IIIC1: Cancer has spread to lymph nodes in the pelvic area but not lymph nodes around the aorta or distant parts of the body.
- Stage IIIC2: Cancer has spread to lymph nodes around the aorta but not distant parts of the body.
Stage IV (4)
Cancer has spread to distant organs in other parts of the body.
- Stage IVA: Cancer has spread to the inner lining of the rectum or bladder but not distant parts of the body.
- Stage IVB: Cancer has spread to the lining of the abdomen (peritoneum).
- Stage IVC: Cancer has spread to distant parts of the body or to lymph nodes outside the abdomen or above the kidneys.
How to Know Your Endometrial Cancer Stage
After you are diagnosed with endometrial cancer, you will have imaging scans and other tests, like biopsies, to tell if the cancer has spread and to where. In a biopsy, a pathologist checks samples of tissue under a microscope to see if they contain cancer cells.
For endometrial cancer, staging is typically done at the time of surgery. This means you and your care team will probably need to wait until after surgery to make some of your treatment decisions.
Endometrial Cancer Survival Rates
In cancer care, “survival rate” usually means the percentage of people expected to survive their cancer for at least five years from the time it was diagnosed. Data experts estimate this rate based on information about large groups of people with the same type of cancer. The rate doesn’t include the risk of dying during that five years for some other reason. For endometrial cancer, the relative five-year survival rate overall in the United States is 84%, according to data from the National Cancer Institute.
But the chance of surviving cancer for five years or more can be quite different from person to person. One important reason is the stage of the disease at the time of diagnosis. Even within a subset of people, like those with localized disease (endometrial cancer that’s only in the area where it started), there will be differences. Patients may have different treatments and respond to treatments in different ways.
This means it’s impossible to predict the likely lifespan of any one person based on survival rates. If you would like to know more about the outlook for your disease, talk with your Fred Hutch care team. They can tell you more based on your unique situation.
The TNM staging system is another way to describe how far endometrial cancer has spread. (This system is used for many other types of cancer too.) The letters stand for:
- Tumor (T): The size of the main tumor and any spread of cancer into nearby tissue
- Nodes (N): The number of nearby lymph nodes where cancer has spread
- Metastasis (M): If cancer has spread (metastasized) to other parts of the body
In the TNM system, there will be a symbol after each letter to give details; for example, T1N0M0. In T1, the 1 indicates the size of the tumor (small). In N0, the 0 means there’s no sign of cancer in nearby lymph nodes. In M0, the 0 means cancer hasn’t spread to distant parts of the body. If you would like to know the stage of your cancer in the TNM system, ask your Fred Hutch care team.
At Fred Hutch, we will tailor your treatment plan to you. In general, people who have the same stage of endometrial cancer often have the same or similar treatments. The grade of your cancer (how aggressive it is) also matters. Common treatments by stage may include:
- Stage I (1) and stage II (2): Surgery to remove the tumor. Sometimes surgeons need to remove nearby organs or lymph nodes. Some people have radiation therapy or chemotherapy after surgery.
- Stage III (3) and stage IV (4): Surgery to remove the tumor, if possible, along with lymph nodes in the pelvis, and then radiation therapy, chemotherapy or both. For people with endometrial cancer stage 3 or 4 who cannot have surgery, options may include radiation therapy, chemotherapy, hormone therapy, targeted therapy or immunotherapy.
Learn more about endometrial cancer treatment.
Researchers at Fred Hutch and beyond are always looking for better ways to treat advanced or metastatic endometrial cancer. Clinical trials are going on to test new drugs or new combinations of drugs. Two important areas of research are targeted therapies and immunotherapies. Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy. Immunotherapies use the power of your immune system to fight your cancer.
Learn more about endometrial cancer treatment.