Gynecologic Oncology Program

Endometrial Cancer

Stages

If a patient has cancer of the endometrium, her doctor will do more tests to find out if the cancer cells have spread to other parts of the body. This is called staging. To plan treatment, a doctor needs to know the stage of the disease.

The following stages are used for cancer of the endometrium:

Stage I: In three-quarters of cases, cancer is found only in the main part of the uterus, but not in the cervix. Treatment may be one of the following:

Surgery to remove the uterus and both ovaries and fallopian tubes (total abdominal hysterectomy and bilateral salpingo-oophorectomy), with or without removal of some of the lymph nodes in the pelvis and abdomen to see if they contain cancer
Total abdominal hysterectomy and bilateral salpingo-oophorectomy with removal of some of the lymph nodes in the pelvis and abdomen to see if they contain cancer, followed by radiation therapy to the pelvis
Clinical trials of radiation and/or chemotherapy following surgery for selected high-risk patients
Radiation therapy alone for selected patients who are too sick to have surgery (< 5 percent of all patients)

Stage II: Cancer cells have spread to the cervix. Treatment may be one of the following:

Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and removal of some of the lymph nodes in the pelvis and abdomen to see if they contain cancer, followed by radiation therapy.
Internal and external beam radiation therapy followed by surgery to remove the uterus and both ovaries and fallopian tubes (total abdominal hysterectomy and bilateral salpingo-oophorectomy). Some of the lymph nodes in the pelvis and abdomen are also removed to see if they contain cancer.
Surgery to remove the cervix, uterus, fallopian tubes, ovaries, and part of the vagina (radical hysterectomy). Lymph nodes in the area may also be taken out (lymph node dissection).

Stage III: Cancer cells have spread outside the uterus but have not spread outside the pelvis. Treatment may be one of the following:

Surgery to remove the cervix, uterus, fallopian tubes, ovaries, and part of the vagina (radical hysterectomy). Lymph nodes in the area may also be taken out (lymph node dissection). Surgery is usually followed by radiation therapy.
Internal and external beam radiation therapy.
Hormone therapy or chemotherapy in a clinical trial.

Stage IV: Cancer cells have spread beyond the pelvis, to other body parts, into the lining of the bladder (the sac which holds urine), or to the rectum. Treatment may be one of the following:

Internal and external-beam radiation therapy
Hormone therapy
Clinical trials of chemotherapy

Recurrent: Recurrent disease is cancer that has come back (recurred) after it has been treated. If the cancer has come back, treatment may be one of the following:

Radiation therapy to relieve symptoms such as pain, nausea, and abnormal bowel functions
Hormone therapy
Clinical trials of chemotherapy

This page was last updated on: March 3, 2008.