子宫内膜癌

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Endometrial Cancer

Carcinoma of the body of the uterus is not surgically staged (1988). Procedures previously used for differentiation of stages (such as findings of a D&C) are no longer applicable. There may be a small number of patients with corpus cancer who will be treated primarily with radiation therapy. In those instances, clinical staging adopted by FIGO in 1971 would still apply, but designation of that staging system should be noted.

In all stages of carcinoma of the corpus, stages should be grouped with regard to degree of differentiation of adenocarcinoma as follows:

Non-Squamous or Non-Morular Solid Growth Pattern

G1 = <=5% G2 = 6-50% G3 = >50%

Stage		Grade
0		G123	Carcinoma in situ. Histologic findings suspicious of malignancy. Cases of Stage 0 should not be included in any therapeutic statistics.
I		G123	Carcinoma confined to corpus
	IA	G123	Tumor limited to endometrium
	IB	G123	Invasion to <1/2 myometrium
	IC	G123	Invasion to >1/2 myometrium
II		G123	Involvement of corpus and cervix
	IIA	G123	Endocervical glandular involvement only
	IIB	G123	Cervical stromal invasion
III		G123	Extension outside uterus, but not outside true pelvis.
	IIIA	G123	Tumor invades serosa and/or adnexae and/or positive peritoneal cytology
	IIIB	G123	Vaginal metastasis
	IIIC	G123	Metastasis to pelvic and/or para-aortic nodes
IV		G123	Extension outside true pelvis or obvious involvement of bladder or rectal mucosa. Bullous edema does not permit assignment of a case to Stage IV.
	IVA	G123	Tumor invasion of bladder and/or bowel mucosa
	IVB	G123	Distant metastasis, including intraabdominal and/or inguinal lymph nodes.

Notes

-- Notable nuclear atypia, inappropriate for architectural grade, raises a grade 1 or grade 2 tumor by 1.

-- In serous adenocarcinomas, clear cell adenocarcinomas, and squamous cell carcinomas, nuclear grading takes precedent.

-- Adenocarcinomas with squamous differentiation are graded according to nuclear grade of glandular component.