classification of stage of endometrial cancer

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Endometrium carcinoma is generally staged according to the International Federation of Gynecology and Obstetrics (FIGO)

Revised (2009) FIGO staging of endometrial cancer:

  • stage I -confined to the corpus uteri
    • I A - no myometrial invasion or less than half
    • I B - invasion equal to or more than half the myometrium
  • stage II - tumour invades cervical stroma but does not extend beyond uterus
  • stage III - local and/or regional spread of the tumour
    • III A - tumour invades serosa of corpus uteri and/or adnexae
    • III B - vaginal and/or parametrial involvement
    • III C - metastases to pelvic and/or para-aortic lymph nodes
    • III C1 - positive pelvic nodes
    • III C2 - positive para-aortic lymph nodes with or without positive pelvic 
  • stage IV – tumour invades bladder and/or bowel mucosa and/or distant  metastases
    • IVA - tumour invasion of bladder and/or bowel mucosa
    • IV B - distant metastases, including intra-abdominal metastases and/or  inguinal lymph nodes

Furthermore cases of carcinoma of the corpus should be grouped with regard to the degree of differentiation of the adenocarcinoma as follows:

  • G1: <5% of a nonsquamous or nonmorular solid growth pattern
  • G2: 6%–50% of a nonsquamous or nonmorular solid growth pattern
  • G3: >50% of a nonsquamous or nonmorular solid growth pattern (2)

Note:

  • notable nuclear atypia (pleomorphism and prominent nucleoli), inappropriate for the architectural grade, raises the grade of a Grade 1 or Grade 2 tumor by 1
  • in serous and clear cell adenocarcinomas, nuclear grading takes precedent. Most authors consider serous and clear cell carcinomas high grade by definition

Reference:

Last reviewed 01/2018

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