Once endometrial cancer has been diagnosed, doctors perform tests to determine the stage of the cancer. Staging is the process of determining:
- The grade of your cancer (how abnormal the cells look and how likely the cancer is to grow and spread)
- Whether (and how deeply) it has invaded your uterus’s muscle layer
- Whether it has spread outside your uterus
Doctors use a cancer’s stage as a key factor in making treatment recommendations and estimating a patient’s chance for recovery. For endometrial cancer, staging is typically done at the time of surgery, which means you and your healthcare team will probably need to wait until after surgery to make some of your treatment decisions.
The most common staging system for gynecological cancers is the International Federation of Gynecology and Obstetrics (FIGO) 2010 system. This is the system that gynecologic oncologists at Seattle Cancer Care Alliance use.
- Stage I: Cancer is only in the body of the uterus (that is, only in the upper uterus, not in the cervix). It may have spread from the endometrium into the myometrium. There’s no cancer in the supporting connective tissue (stroma) of the cervix or outside the uterus.
- Stage II: Cancer has spread to the supporting connective tissue of the cervix but not beyond the uterus.
- Stage III: Cancer has spread outside the uterus to nearby tissue in the pelvic area—the outer surface of the uterus (serosa), the fallopian tubes, the ovaries, the vagina, the parametrium (tissue around the uterus), or regional lymph nodes (pelvic or para-aortic nodes). It has not spread outside the pelvic area.
- Stage IV: Cancer has spread to the bladder or bowel, lymph nodes in the groin (inguinal nodes), or organs outside the pelvis, such as the lungs, liver, or bones.