TABLE 241-1. STAGING OF ENDOMETRIAL CARCINOMA

TABLE 241-1. STAGING OF ENDOMETRIAL CARCINOMA^a
Stage^b	Definition
IA IB IC IIA IIB IIIA IIIB IIIC IVA IVB	Tumor limited to endometrium Invasion of < 1/2 myometrium Invasion of > 1/2 myometrium Tumor involves only endocervical glands Invasion of cervical stroma Invasion of serosa and/or adnexa and/or positive peritoneal cytologic results Metastases to vagina Metastases to pelvic and/or paraaortic lymph nodes Invasion of bladder and/or bowel mucosa Distant metastases, including intraabdominal and/or inguinal lymph nodes
^aAs described by the International Federation of Gynecology and Obstetrics (FIGO), 1988. Endometrial cancer is now surgically staged, so procedures previously used to differentiate stages no longer apply. However, the clinical staging adopted by FIGO in 1971 still applies to a few patients who may be treated primarily with radiation therapy, but use of that staging system should be noted. Ideally, in current staging, width of the myometrium should be measured with the width of tumor invasion.
^bFor all but stage IVB, the percentage of the tumor with a nonsquamous or nonmorular solid growth pattern is indicated by G1 (≤ 5 %), G2 (6-50%), or G3 (> 50 %). Notable nuclear atypia inappropriate for the architectural grade raises the grade of a G1 or G2 tumor by 1. In serous adenocarcinomas, clear cell adenocarcinomas, and squamous cell carcinomas, nuclear grading takes precedence. Adenocarcinomas with squamous differentiation are graded according to the nuclear grade of the glandular component.