Uterine Cancer: Stages and Grades

Approved by the Cancer.Net Editorial Board, 12/2022

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


What is cancer staging?

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 collected during surgery. Because of this, staging may not be complete until all of the tests are finished and the surgery to remove the tumor has been done (see Types of Treatment). Knowing the stage helps the doctor recommend the best kind of treatment and can help predict a patient'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 (FIGO) is used.

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FIGO stages for uterine adenocarcinomas

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 has penetrated through 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 (the supportive tissues around the cervix) 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 to the tissue immediately next to the uterus called the parametrium.

  • Stage IIIC1: The cancer has spread to the regional pelvic lymph nodes. Lymph nodes are small, bean-shaped organs that help fight infection.

  • 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.

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Grade (G)

Doctors also describe this type of cancer by its grade (G). The grade 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 has 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 grow. In general, the slower the growth, 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.

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Recurrent uterine cancer

Recurrent cancer is cancer that has come back after treatment. Uterine cancer may come back in the vagina, the uterus (if this organ has not been removed), the pelvis, the lymph nodes of the abdomen, or in another part of the body. If there is a recurrence, this tends to occur within 3 years of the original diagnosis, but later recurrences can sometimes occur as well.

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

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