Staging is the process of analyzing information about a tumor to find out how far the cancer has spread. The stage of a uterine sarcoma is the most important factor in choosing treatment. Ask your health care team to explain your cancer's stage so that you can make fully informed choices about your treatment.

The system used to stage endometrial cancer is called the FIGO (International Federation of Gynecology and Obstetrics) system of staging. This is a surgical staging system. This means that staging is based on examination of tissue removed during an operation. The FIGO system classifies the cancer in stages I through IV, with each of these stages being further divided by letters (for example, stages IIA, IIB, and IIC). The FIGO staging system that is used for uterine sarcomas is the same as the one used to stage endometrial carcinomas.

The staging system looks at how far the cancer has spread. It can spread locally to other parts of the uterus. It can also spread regionally to nearby lymph nodes (bean-sized organs that are part of the immune system). The regional lymph nodes are found in the pelvis and farther away along the aorta (the main artery that runs from the heart down along the back of the abdomen and pelvis). The lymph nodes along the aorta are called para-aortic nodes. Finally, the cancer can spread (metastasize) to distant lymph nodes or organs such as lung, liver, bone, brain, and others.

Stage I: The cancer is only in the main body of the uterus. It has not spread to the cervix, lymph nodes, or distant sites.

Stage IA: The cancer is only in the lining of the uterus (the endometrium).

Stage IB: The cancer has spread from the endometrium into the myometrium (muscular wall of the uterus), growing less than halfway through the myometrium.

Stage IC: The cancer has spread from the endometrium into the myometrium, growing more than halfway through the myometrium. The cancer has not spread beyond the body of the uterus.

Stage II: The cancer has spread from the body of the uterus to the cervix (the lower part of the uterus next to the vagina). The cancer has not spread to lymph nodes or distant sites.

Stage IIA: The cancer involves the body of the uterus and the lining of the cervix.

Stage IIB: The cancer is in the body of the uterus and has grown through the lining of the cervix and into the supporting connective tissue (called the cervical stroma).

Stage III: The cancer has spread outside the uterus but is still only in the pelvic area.

Stage IIIA: The cancer has not spread to lymph nodes or distant sites, but it has spread to:

• the layer of tissue on the outer surface of the uterus (the serosa)
• the fallopian tubes or ovaries (adnexa)
• the peritoneal fluid (fluid from the inner lining of the pelvis and abdomen).

Stage IIIB: The cancer has spread beyond the uterus to the vagina. It has not spread to lymph nodes or distant sites.

Stage IIIC: The cancer has spread to lymph nodes near the uterus (pelvic and/or para-aortic lymph nodes).

Stage IV: The cancer has spread to the inner surface of the urinary bladder or the rectum (lower part of the large intestine), to lymph nodes in the groin, and/or to distant organs, such as the bones or lungs.

Stage IVA: The cancer has spread to the inner lining of the rectum or urinary bladder (called the mucosa). It may also be in the lymph nodes but has not spread to distant sites.

Stage IVB: The cancer has spread to organs that are not next to the uterus (such as the bones or lungs) or it has spread to distant lymph nodes (such as those in the groin area).

Survival rates by stage

The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Five-year rates are used to produce a standard way of discussing prognosis. Of course, many people live much longer than 5 years. Five-year relative survival rates compare the survival of people with the cancer to the survival for people without the cancer. Since some people will die of causes other than cancer, this is a way to look only at deaths from the specific cancer. The 5-year relative survival rate is a more accurate way to describe the outlook for patients with a particular type and stage of cancer. Remember that these numbers are based on patients diagnosed at least 5 years ago. Improvements in treatment since that time may have improved survival for women diagnosed more recently.

The outlook for survival (prognosis) for women with a uterine sarcoma depends on many factors. These include

• The stage of the cancer,
• The type of sarcoma (leiomyosarcoma or endometrial stromal sarcoma),
• The grade of the sarcoma (low grade versus high grade), and
• The patient's general state of health.

The survival statistics noted below are estimates based on studies of women with uterine sarcomas. Although they reflect the average outlook for groups of patients, it is important to always remember that people are not statistics. Every person is different, and every person will have his/her own experience with cancer and its treatment.

The 5-year relative survival rates for leiomyosarcoma are:

The 5-year relative survival rates for endometrial stromal sarcoma are:

Last Medical Review: 11/18/2009
Last Revised: 11/18/2009