Staging is very important when diagnosing cancer, as it lets your doctors know important information about your tumors and how much your cancer has spread. For uterine cancer, staging is even more important, as it is the main factor that determines a treatment plan.
There are two different staging systems that are used for staging uterine cancer, including the FIGO (International Federation of Gynecology and Obstetrics) and the American Joint Committee on Cancer’s TNM staging system. Both systems stage cancer based on three different factors: the extent of the tumor (T), if the cancer has spread to the lymph nodes (N), and whether the cancer has metastasized to other parts of the body (M).
Staging for uterine cancer will usually begin with examining a tissue sample that is removed during an operation. Although there are some tests that can give doctors a good idea about how much the cancer has spread, it is impossible to definitively stage uterine cancer before surgery. The staging system for uterine cancer is based on how much the cancer has spread. This is broken up into three different categories:
- Locally: Uterine cancer that spreads locally means that it has spread to other parts of the uterus and possibly to the cervix.
- Regionally: If your uterine cancer spreads regionally, this means that the tumor has reached nearby lymph nodes, such as those in the pelvis or the aorta.
- Distantly: If the cancer metastasizes to farther away parts of the body, this includes distant lymph nodes, the upper abdomen, the omentum, the lungs, liver, bone, brain, or other organs.
The staging process for uterine cancer starts with classifying any tumors that are present in the uterus. Uterine cancer begins with cancer cells on the surface layer of the endometrium (Tis), then progresses to the body of the uterus and the glands of the cervix (T1). Next, the tumor will grow into the supporting connective tissue of the cervix, but not outside of the uterus yet (T2). Finally, the tumor will grow large enough to spread outside of the uterus (T3) to the vagina and the inner lining of the rectum and bladder (T4).
Lymph Node Spread
In early stages of uterine cancer, the cancer will not affect the nearby lymph nodes (N0). The first lymph nodes the cancer will logically spread to are the lymph nodes in the pelvis (N1). Finally, the cancer will spread to distant lymph nodes throughout the body (N2).
When a cancer has metastasized, this means that it has spread throughout the body to distant lymph nodes, organs, and tissue. The classification for this staging process only has two categories: the cancer has not spread to distant lymph nodes, organs, or tissues (M0), or the cancer has spread to distant lymph nodes and other organs such as the abdomen, lung, liver, or brain (M1).
Doctors will then use this information to stage your uterine cancer from Stage 0 to Stage IV—with 0 being the least severe and IV being the most.