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4. Staging

4.1 Clinico-Pathologic Considerations

Gross Description

Gross description of the hysterectomy specimen should include:
  1. Whether the tumour is in a polyp or not
  2. Location of the tumour within the uterus (fundus, or lower uterine segment)
  3. The depth of myometrial invasion (luminal or serosal half)
  4. The presence or absence of cervical stromal involvement
Microscopic Description

  1. The histologic type
  2. The histologic grade (1-3) 
  3. Myometrial invasion if present 
    • Luminal half (less than 50% invasion)
    • Serosal half (more than 50% invasion)
  4. The presence or absence of lymphatic or vascular invasion and extent
  5. Perilymphatic inflammation (slight, moderate, marked)
  6. Cervical involvement (endocervical or stromal involvement)
  7. Lymph node involvement
  8. Adnexal involvement
  9. Cytology of peritoneal fluid, if obtained

4.2 Staging Diagram

Download the Corpus Uteri Staging Diagram here.

4.3 Preoperative Investigations for Staging

  • chest x-ray 
  • imaging with CT or U/S as appropriate (if suspicion of extrauterine disease, or if unable to assess the size of the uterus)
  • tumor markers: CA 125 is most helpful, as an elevated CA125 is associated with extrauterine disease, CA 19-9, CA 15-3, CEA

SOURCE: 4. Staging ( )
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