Uterine Sarcoma Stages

After a woman is diagnosed with uterine sarcoma, doctors will try to figure out if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes the amount of cancer spread in the body and helps determine how best to treat it. Doctors also use a cancer's stage when talking about survival statistics.

Uterine sarcoma stages range from stage I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more. And sometimes, a stage might be divided further using letters. An earlier letter means a lower stage. Although each person’s cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated in much the same way.

How is the stage determined?

The systems used to stage uterine sarcoma, the FIGO (International Federation of Gynecology and Obstetrics) system and the (AJCC) American Joint Committee on Cancer TNM staging system are basically the same.

They both stage (classify) this cancer based on 3 factors:

• The extent (size) of the tumor (T): How large is the cancer? Has the cancer grown out of the uterus into the pelvis or organs such as the bladder or rectum?
• The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes?
• The spread (metastasis) to distant sites (M): Has the cancer spread to distant lymph nodes or organs?

Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a person’s T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage.

The staging system in the table below uses the pathologic stage (also called the surgical stage). It is determined by examining tissue removed during an operation. Sometimes, if surgery is not possible, the cancer will be given a clinical stage instead. This is based on the results of a physical exam, biopsy, and imaging tests done without surgery. For more information see Cancer Staging.

The system described below is the most recent AJCC system, effective January 2018. It is only for staging leiomyosarcoma and endometrial stromal sarcoma.

Uterine sarcoma staging can be complex, so ask your doctor to explain it to you in a way you understand.

Stage	Stage grouping	FIGO Stage	Stage description*
I	T1 N0 M0	I	The cancer is growing in the uterus, but has not started growing outside the uterus. It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IA	T1a N0 M0	IA	The cancer is only in the uterus and is no larger than 5 cm across (about 2 inches) (T1a). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IB	T1b N0 M0	IB	The cancer is only in the uterus and is larger than 5 cm across (about 2 inches). (T1b). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
II	T2 N0 M0	II	The cancer is growing outside the uterus but is not growing outside of the pelvis (T2). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IIIA	T3a N0 M0	IIIA	The cancer is growing into tissues of the abdomen in one place only (T3a). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IIIB	T3b N0 M0	IIIB	The cancer is growing into tissues of the abdomen in 2 or more places (T3b). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IIIC	T1-T3 N1 M0	IIIC	The cancer is growing in the body of the uterus and it might have spread into tissues of the abdomen, but is not growing into the bladder or rectum (T1 to T3). The cancer has spread to nearby lymph nodes (N1), but not to distant sites (M0).
IVA	T4 Any N M0	IVA	The cancer has spread to the rectum or urinary bladder (T4). It might or might not have spread to nearby lymph nodes (Any N) but has not spread to distant sites (M0).
IVB	Any T Any N M1	IVB	The cancer has spread to distant sites such as the lungs, bones, or liver (M1). The cancer in the uterus can be any size and may or may not have grown into tissues in the pelvis and/or abdomen (including the bladder or rectum) (any T) and it might or might not have spread to nearby lymph nodes (Any N).

* The following additional categories are not listed on the table above:

• TX: Main tumor cannot be assessed due to lack of information.
• T0: No evidence of a primary tumor.
• NX: Regional lymph nodes cannot be assessed due to lack of information.