Uterine cancer stages

Making an educated treatment decision begins with the stage, or progression, of your uterine cancer. Using the results from your diagnostic tests, your care team at Cancer Treatment Centers of America^® (CTCA) will develop an appropriate treatment plan for you.

If you have been recently diagnosed, we will review your pathology to confirm you have received the correct diagnosis and staging information, and develop a personalized treatment plan. If you have a recurrence, we will perform comprehensive testing and identify a treatment approach that is suited to your needs.

Uterine cancer is staged using the American Joint Committee on Cancer TNM system:

T (tumor) This describes the size of the original tumor.

N (node) This indicates whether the cancer is present in the lymph nodes.

M (metastasis) This refers to whether cancer has spread to other parts of the body, usually the liver, bones or brain.

Once the T, N and M scores have been assigned, an overall stage is assigned.

The International Federation of Gynecology and Obstetrics has a similar staging system known as FIGO. Unlike the TNM system, the FIGO system does not include stage 0.

Stage 0: This stage is also known as carcinoma in-situ. Cancer cells are only found in the surface layer of cells of the endometrium, without growing into the layers of cells below. The cancer has not spread to nearby lymph nodes or distant sites. This is a pre-cancerous lesion. This stage is not included in the FIGO staging system.

Stage I (stage 1 uterine cancer): The cancer is only growing in the body of the uterus. It may also be growing into the glands of the cervix but is not growing into the supporting connective tissue of the cervix. The cancer has not spread to lymph nodes or distant sites. This stage has two subcategories: 

• Stage IA: In this earliest form of stage I, the cancer is in the endometrium (inner lining of the uterus) and may have grown from the endometrium less than halfway through the underlying muscle layer of the uterus (the myometrium). It has not spread to lymph nodes or distant sites.
• Stage IB: The cancer has grown from the endometrium into the myometrium, growing more than halfway through the myometrium. The cancer has not spread beyond the body of the uterus.

Stage II (stage 2 uterine cancer): The cancer has spread from the body of the uterus and is growing into the supporting connective tissue of the cervix (called the cervical stroma). The cancer has not spread outside of the uterus. The cancer has not spread to lymph nodes or distant sites.

Stage III (stage 3 uterine cancer): The cancer has either spread outside of the uterus or into nearby tissues in the pelvic area. This stage has four subcategories: 

• Stage IIIA: The cancer has spread to the outer surface of the uterus (called the serosa) and/or to the fallopian tubes or ovaries (the adnexa). The cancer has not spread to lymph nodes or distant sites.
• Stage IIIB: The cancer has spread to the vagina or to the tissues around the uterus (the parametrium). The cancer has not spread to lymph nodes or distant sites.
• Stage IIIC1: The cancer is growing in the body of the uterus. It may have spread to some nearby tissues, but is not growing into the inside of the bladder or rectum. The cancer has spread to pelvic lymph nodes but not to lymph nodes around the aorta or distant sites.
• Stage IIIC2: The cancer is growing in the body of the uterus. It may have spread to some nearby tissues, but is not growing into the inside of the bladder or rectum. The cancer has spread to lymph nodes around the aorta (peri-aortic lymph nodes) but not to distant sites.

Stage IV (stage 4 uterine cancer): The cancer has spread to the inner surface of the urinary bladder or the rectum (lower part of the large intestine), to lymph nodes in the groin, and/or to distant organs, such as the bones, omentum or lungs. Stage IV uterine cancer has two subcategories: 

• Stage IVA: The cancer has spread to the inner lining of the rectum or urinary bladder (called the mucosa). It may or may not have spread to nearby lymph nodes but has not spread to distant sites.
• Stage IVB: The cancer has spread to distant lymph nodes, the upper abdomen, the omentum, or to organs away from the uterus, such as the bones, omentum, or lungs. The cancer can be any size and it may or may not have spread to lymph nodes.

Next topic: How is uterine cancer diagnosed?