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Updated May 2018
(corrected to exclude death from intercurrent disease)
Proportion of all patients
5-year overall survival
Tumour confined to corpus uteri
Tumour limited to endometrium or invades less than one half of the myometrium
Tumour invades one half or more of the myometrium
Tumour invades stromal connective tissue of the cervix but does not extend beyond uterus
Local and/or regional spread
Tumour involves serosa and/or adnexae (direct extension or metastases)
Vaginal involvement (direct extension or metastasis) or parametrial involvement
Metastases to pelvic and/or para-aortic lymph nodes
Regional lymph node metastases to pelvic lymph nodes
Regional lymph node metastasis to para-aortic lymph nodes, with or without positive pelvic lymph nodes
Tumour invades bladder mucosa and/or bowel mucosa, and/or distant metastases
Tumour invades bladder mucosa and/or bowel mucosa (bullous edema is not sufficient to classify a tumour as T4)
Distant metastases (includes metastases to inguinal lymph nodes, intraperitoneal disease, or lung, liver, or bone metastases)
Changes from previous staging system:
NB: Omentum or peritoneal disease = Stage IVB
It should be noted that these figures are approximations of five-year survival data collected from large numbers of patients within a given stage (FIGO data). Caution should be used in attempting to use these data to assign prognosis in an individual case as outcomes within these substages will worsen depending on grade and histotype (e.g., papillary serous and MMMT).
With respect to prevention, weight loss in obese women and improving glycemic control in diabetic women may have the most potential for reducing risk in these specific populations. The use of combination oral contraceptives has been shown to decrease risk by 50% if used for 5 or more years (1). The addition of a progestin to estrogen replacement therapy counteracts the adverse effects of unopposed estrogen on the endometrium2.
Screening for endometrial cancer (endometrial biopsy, transvaginal ultrasound, CA125) has never proven to be effective in asymptomatic women. There is a role for endometrial biopsy to gauge response to therapy for women who are using progestins as fertility-sparing or conservative management for endometrial hyperplasia/cancer. Women on tamoxifen have an increased risk of endometrial cancer. However, screening asymptomatic women on tamoxifen is not recommended. Only those who develop abnormal uterine bleeding need endometrial sampling.
Mixed Epithelial-Mesenchymal Tumors
Download the Corpus Uteri Staging Diagram here.
Number of Risk Factors*
Risk of recurrence without adjuvant therapy
Stage IA, grade 1 or 2
Stage IA, grade 3 or Stage 1B, grade 1
Stage IB, grade 3
C, P, V
O=observation V=vault brachytherapy P=pelvic radiation C=chemotherapy
In all situations outlined below, history and physical exam, including pelvirectal examination, are recommended. Patients do not need routine bloodwork, pap smear, or imaging, unless indicated by symptoms or signs on examination1,2.
These patients are at low risk of recurrence (<5%), which is most likely to occur within the first 2 years after primary treatment. The most likely site of recurrence is the vaginal vault, therefore these patients need to be counselled about vaginal bleeding. Their follow-up care can be provided by their referring physician.
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