Endometrial Cancer Staging
|How Is Endometrial Cancer Staged?
Once an endometrial cancer diagnosis has been given, the woman will usually be referred to a gynecological oncologist who specializes in cancers of the reproductive organs. The oncologist may perform tests to find out if cancer cells have spread within the uterus or to other parts of the body. The process of determining how far a cancer has progressed is called staging. Knowing the stage is important as it will determine the type and extent of treatment for endometrial cancer necessary. If staging is based on examination of tissue removed by surgery this is known as surgical staging. In fact most endometrial cancer cases cannot be staged accurately without surgery. A doctor may also order imaging tests such as ultrasound, MRI scan, CT scan or PET scan to look for signs of cancer throughout the body. This is not usually as accurate as surgery but it may be helpful in providing information for surgery.
The cancer staging system looks at how far the cancer has spread. Endometrial cancer for example can spread locally to other parts of the uterus. It can also spread regionally through the lymph nodes found in the pelvis or slightly further away to the aorta lymph nodes (the main artery which runs down the back of the abdomen and pelvis). Or it can metastasize (spread) to distant lymph nodes or organs like the brain, liver, heart and bones (stage 4).
Abnormal endometrial hyperplasia or carcinoma in situ is evident. Scientists sometimes refer to these cells as pre-cancerous.
Cancer is found in the uterus (womb) only. Cancerous cells have not spread to lymph nodes or distant sites. This stage is further subdivided into 3 other stages:
Stage 1A: Cancer is limited to the endometrium (inner lining of the uterus).
In stage 2, cancer has spread from the body of the uterus to the cervix. Cancer has still not spread to lymph nodes or other parts of the body. This stage is further subdivided into stages 2A and 2B based on how far the cancer has spread into the cervix.
Stage 2A: Cancer has spread to the glands where the cervix and uterus meet (endocervical glandular involvement).
Stage 2B: Cancer has spread to the connective tissue of the cervix (cervical stromal invasion).
In stage 3, cancer has spread outside of the uterus and cervix but not further than the pelvis. This stage is subdivided into 3 further stages based on how far into the pelvis cancer has spread.
Stage 3A: Cancer tumor invades the membrane that surrounds the outer surface of the uterus (serosa); and/or the fallopian tubes and ovaries (adnexa); and/or cells are present in peritoneal fluid (positive peritoneal cytology).
Stage 3B: Cancer has spread beyond the uterus and cervix into the vagina (vaginal metastases).
Stage 3C: Cancer has spread to lymph nodes around the uterus (peri-aortic lymph nodes) but not to distant sites.
In stage 4, cancer has spread beyond the pelvis (image). It is further subdivided depending on how far it has invaded other parts of the body:
Stage 4A: Cancer has spread to the bladder and/or bowel.
Stage 4B: Cancer has spread to other parts of the body beyond the pelvis, including lymph nodes in the abdomen and/or groin (inguinal) lymph nodes. The cancer tumor can be any size.
|Related Articles on Endometrial Cancer Staging
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