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Staging, grading and prognosis of uterine cancer

Staging is a way to describe the size of the cancer and whether it has spread to other parts of the body. In some cases, the imaging scans can show if the cancer has spread, but it is often not possible to be sure of the stage until after surgery. Grading describes how the cancer cells look under a microscope compared to normal cells and how aggressive they may be.

The stage and grade help your doctors work out the risk of the cancer returning and if you need further treatments. The table below shows how endometrial cancers are staged and graded. Uterine sarcomas are staged differently, so discuss this with your specialist.

Staging endometrial cancers

stage IThe cancer is found only in the uterus - early or localised cancer.
stage IIThe cancer has spread from the uterus to the cervix - regionalised cancer.
stage IIIThe cancer has spread beyond the uterus/cervix to the ovaries, fallopian tubes, vagina, or lymph nodes in the pelvis or abdomen - regionalised cancer.
stage IVThe cancer has spread further, to the bladder or rectum, throughout the abdomen, to other parts of the body such as the bones or lung, or to lymph nodes in the groin - metastatic or advanced cancer.

Grading endometrial cancers

grade 1 (low grade)The cancer cells look slightly abnormal.
grade 2 (moderate grade)The cancer cells look moderately abnormal.
grade 3 (high grade)The cancer cells look more abnormal. These cancers tend to be more aggressive than lower-grade cancers.

Prognosis

Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your oncologists. However, it is not possible for anyone to predict the exact course of the disease in an individual person. Instead, your doctor can give you an idea about the general outlook for people with the same type and stage of cancer. You will also have tests to check how the cancer is responding to treatments.

Test results, the type of uterine cancer, the rate and depth of tumour growth, the likelihood of response to treatment, and factors such as your age, level of fitness, and medical history are all important in assessing your prognosis. As for most types of cancer, the outcomes tend to be better when uterine cancer is found and treated early.

This information is reviewed by

This information was last reviewed March 2019 by the following expert content reviewers: A/Prof Alison Brand, Director, Gynaecological Oncology, Westmead Hospital, NSW; Kate Barber, 13 11 20 Consultant, Cancer Council Victoria; Prof Jonathan Carter, Director, Gynaecological Oncology, Chris O’Brien Lifehouse, NSW; Dr Robyn Cheuk, Senior Radiation Oncologist, Royal Brisbane and Women’s Hospital, QLD; Dr Alison Davis, Medical Oncologist, Canberra Region Cancer Centre, The Canberra Hospital, ACT; Kim Hobbs, Clinical Specialist Social Worker, Westmead Hospital, NSW; Nicole Kinnane, Nurse Coordinator, Gynaecology Oncology, Peter MacCallum Cancer Centre, VIC; Jennifer Loveridge, Consumer; Pauline Tanner, Gynaecology Cancer Nurse Coordinator, WA Cancer & Palliative Care Network, North Metropolitan Health Service, WA.