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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 scans performed 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 estimates how fast the cancer is likely to grow.

Knowing the stage and grade helps your doctors recommend the best treatment for your situation. Uterine sarcomas are staged differently, so discuss this with your specialist.

Stages of endometrial cancers

The four stages of endometrial cancer may be divided into sub-stages, such as A, B and C, which indicate increasing amounts of tumour.

stage 1The cancer is found only in the uterus - early or localised cancer.
stage 2The cancer has spread from the uterus to the cervix - regionalised cancer.
stage 3The cancer has spread beyond the uterus/cervix to the ovaries, fallopian tubes, vagina, or lymph nodes in the pelvis or abdomen - regionalised cancer.
stage 4The cancer has spread further, to the bladder, bowel 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.

Grades of 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 with your doctor, but it is not possible for anyone to predict the exact course of the disease. Instead, your doctor can give you an idea about the general outlook for people with the same type and stage of uterine cancer.

To work out your prognosis, your doctor will consider 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.

In general, the earlier cancer of the uterus is diagnosed, the better the outcome. Most early-stage endometrial cancers have a good prognosis with high survival rates. If cancer is found after it has spread to other parts of the body (advanced cancer), the prognosis is not as good and there is a higher chance of the cancer coming back after treatment.

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This information is reviewed by

This information was last reviewed March 2021 by the following expert content reviewers: A/Prof Jim Nicklin, Director, Gynaecological Oncology, Royal Brisbane and Women’s Hospital, and Associate Professor Gynaecologic Oncology, The University of Queensland, QLD; Dr Robyn Cheuk, Senior Radiation Oncologist, Royal Brisbane and Women’s Hospital, QLD; Prof Michael Friedlander, Medical Oncologist, The Prince of Wales Hospital and Conjoint Professor of Medicine, The University of NSW, NSW; Kim Hobbs, Clinical Specialist Social Worker, Gynaecological Cancer, Westmead Hospital, NSW; Adele Hudson, Statewide Clinical Nurse Consultant, Gynaecological Oncology Service, Royal Hobart Hospital, TAS; Dr Anthony Richards, Gynaecological Oncologist, The Royal Women’s Hospital and Joan Kirner Women’s and Children’s Hospital, VIC; Georgina Richter, Gynaecological Oncology Clinical Nurse Consultant, Royal Adelaide Hospital, SA; Deb Roffe, 13 11 20 Consultant, Cancer Council SA.