Gynecology Book

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Endometrial Cancer Staging

Aka: Endometrial Cancer Staging
  1. Stages: International Federation of Gynecology and Obstetrics TNM System (2009)
    1. Stage I: Tumor limited to uterine corpus
      1. Stage Ia: Tumor limited to endometrium or myometrium invasion <50% (90% five year survival)
      2. Stage Ib: Myometrium invasion 50% or more (78% five year survival)
    2. Stage II: Tumor invades Cervix and uterine corpus (74% five year survival)
    3. Stage III: Tumor local or regional spread
      1. Stage IIIa: Peritoneum and serosa involvement, Adnexa may also be involved (57% five year survival)
      2. Stage IIIb: Tumor invades vagina (36% five year survival)
      3. Stage IIIc: Pelvic or para-aortic lymph node involvement
        1. Stage IIIc1: Regional lymph node metastasis to pelvic lymph node (57% five year survival)
        2. Stage IIIc2: Regional lymph node metastasis to para-aortic lymph nodes (49% five year survival)
    4. Stage IV: Intra-abdominal or distant metastases
      1. Stage IVa: Invasion of Bladder or bowel mucosa
      2. Stage IVb: Distant metastasis (includes intra-abdominal and inguinal lymph node spread)
    5. References
      1. Buchanan (2009) Am Fam Physician 80(10): 1075-88 [PubMed]
  2. Stages: Older, 1988 System
    1. Stage I: Tumor limited to uterine corpus (85-91% five year survival)
      1. Stage Ia: Tumor limited to endometrium
      2. Stage Ib: Myometrium invasion <50%
      3. Stage Ic: Myometrium invasion 50% or more
    2. Stage II: Tumor invades Cervix and uterine corpus (74-83% five year survival)
      1. Stage IIa: Endocervical gland involvement
      2. Stage IIb: Invasion of cervical stroma
    3. Stage III: Tumor local or regional spread (57-66% five year survival)
      1. Stage IIIa: Peritoneum and serosa involvement (Adnexa may also be involved)
      2. Stage IIIb: Tumor invades vagina
      3. Stage IIIc: Pelvic or para-aortic lymph node involvement
    4. Stage IV: Intra-abdominal or distant metastases (20-25% five year survival)
      1. Stage IVa: Bladder or bowel mucosa invasion
      2. Stage IVb: Distant metastases (includes intra-abdominal and inguinal lymph node spread)
    5. References
      1. Creaman (2006) In J Gynaecol Obstet 95(suppl 1): S105-43 [PubMed]
      2. Sorosky (2008) Obstet Gynecol 111(2 pt 1): 436-47 [PubMed]

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