Uterine Cancer: Stages and Grades

Approved by the Cancer.Net Editorial Board, 06/2017

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to discover the cancer's stage, and they may need information based on samples of tissue from surgery, so staging may not be complete until all of the tests are finished and the surgery to remove the tumor has been done (see Treatment Options). Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a woman's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer. For uterine cancer, the staging system developed by the International Federation of Obstetrics and Gynecology (Federation Internationale de Gynecologie et d'Obstetrique or FIGO) is used.

FIGO stages for uterine cancer

The stage provides a common way of describing the cancer, enabling doctors to work together to plan the best treatments. Doctors assign the stage of endometrial cancer using the FIGO system.

Stage I: The cancer is found only in the uterus or womb, and it has not spread to other parts of the body.

  • Stage IA: The cancer is found only in the endometrium or less than one-half of the myometrium.

  • Stage IB: The tumor has spread to one-half or more of the myometrium.

Stage II: The tumor has spread from the uterus to the cervical stroma but not to other parts of the body.

Stage III: The cancer has spread beyond the uterus, but it is still only in the pelvic area.

  • Stage IIIA: The cancer has spread to the serosa of the uterus and/or the tissue of the fallopian tubes and ovaries but not to other parts of the body.

  • Stage IIIB: The tumor has spread to the vagina or next to the uterus.

  • Stage IIIC1: The cancer has spread to the regional pelvic lymph nodes

  • Stage IIIC2: The cancer has spread to the para-aortic lymph nodes with or without spread to the regional pelvic lymph nodes

Stage IV: The cancer has metastasized to the rectum, bladder, and/or distant organs.

  • Stage IVA: The cancer has spread to the mucosa of the rectum or bladder.

  • Stage IVB: The cancer has spread to lymph nodes in the groin area, and/or it has spread to distant organs, such as the bones or lungs.

Grade (G)

Doctors describe this type of cancer by its grade (G), which describes how much cancer cells resemble healthy cells when viewed under a microscope.

The doctor compares the cancerous tissue with healthy tissue. Healthy tissue usually contains many different types of cells grouped together. If the cancer appears similar to healthy tissue and contains different cell groupings, it is called differentiated or a low-grade tumor. If the cancerous tissue looks very different from healthy tissue, it is called poorly differentiated or a high-grade tumor. The cancer’s grade may help the doctor predict how quickly the cancer will spread. In general, the lower the tumor’s grade, the better the prognosis.

The letter "G" is used to define a grade for uterine cancer.

GX: The grade cannot be evaluated.

G1: The cells are well differentiated.

G2: The cells are moderately differentiated.

G3: The cells are poorly differentiated.

Recurrent uterine cancer

Recurrent cancer is cancer that has returned after treatment. Uterine cancer may come back in the uterus, pelvis, lymph nodes of the abdomen, or another part of the body. If there is a recurrence, this tends to occur within 3 years of diagnosis, but later recurrences can sometimes occur. Some symptoms of recurrent cancer are similar to those experienced when the disease was first diagnosed.

  • Vaginal bleeding or discharge

  • Pain in the pelvic area, abdomen, or back of the legs

  • Difficulty or pain when urinating

  • Weight loss

  • Persistent cough/shortness of breath

If there is a recurrence, more testing will help to determine the extent of disease. You and your doctor should talk about treatment options.

Information about the cancer’s stage and grade will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. You may use the menu to choose a different section to read in this guide.