Understanding Your Stage and Grade of Endometrial Cancer

Stage is the word doctors use to describe where the tumor is and how far the cancer has spread. Doctors use stages 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 system to stage endometrial cancer is called FIGO staging. The International Federation of Gynecology and Obstetrics developed this system. The FIGO system uses 4 numbers. Each is described here.

  • Stage I. The cancer is only in the body of the uterus. The body is called the corpus.
  • Stage IA. The cancer is only in the endometrium, which is the uterine lining.
  • Stage IB. The cancer has spread less than halfway through the myometrium, which is the muscular wall of the uterus.
  • Stage IC. The cancer has spread more than halfway through the myometrium, which is the muscular wall of the uterus.
  • Stage II. The cancer has spread to include the end portion of uterus, the cervix.
  • Stage IIA. The cancer is in the body of the uterus and extends to the glands within the cervix (endocervical glands).
  • Stage IIB. The cancer is in the body of the uterus and extends into the support tissue of the cervix (cervical stroma).
  • Stage III. The cancer has spread from the outside of the uterus.
  • Stage IIIA. The cancer has spread to the outer lining (serosa) of the uterus, fallopian tubes, or ovaries; or there are cancer cells in the fluid that surrounds the uterus in the pelvic area.
  • Stage IIIB. The cancer has spread to the vagina.
  • Stage IIIC. The cancer has spread to the lymph nodes in the abdomen and or pelvis.
  • Stage IV. The cancer has spread beyond the pelvic area.
  • Stage IVA. The cancer has spread to the inner lining of the rectum or bladder (mucosa).
  • Stage IVB. The cancer has spread to the lymph nodes in the groin area, or it has spread to other organs, such as the lungs or bones.

Grades of Uterine Cancer

A pathologist is a doctor who specializes in studying cells. A pathologist assesses the sample from your biopsy. He or she assigns a grade to the sample. The grade includes a description of the type of cells in the sample and how much of each type of cells is present. This helps your doctor decide how likely it is that the cancer will spread or return. Doctors use 3 grades to describe most uterine cancers. The higher the grade, the more abnormal appearing are the cancer cells.

  • Grade 1 (low)
  • Grade 2 (intermediate)
  • Grade 3 (high)

In general, higher grade tumors have a greater chance of invading deeper into the uterine wall or spreading outside of the uterus. It is important to understand that some low grade tumors do spread and some high grade tumors do not spread, so grade is not a perfect predictor of how the cancer will behave.