What are the staging criteria for endometrial cancer?

Endometrial cancer can be divided into ten stages based on its symptoms. The symptoms will become more severe as the stage increases, and eventually spread to other distant organs in the body. There are many symptoms of endometrial cancer, such as bleeding, vaginal discharge, pain, abdominal mass, etc. In order to avoid worsening of the disease, active treatment should be carried out after the appearance of these symptoms.

1. Endometrial cancer staging criteria

Stage IA, Grade 1, 2, 3: The cancer is confined to the uterine body. Stage IB, Grade 1, 2, 3: The cancer has invaded less than 1/2 of the myometrium. Stage IC, Grade 1, 2, 3: The cancer has invaded more than 1/2 of the myometrium. Stage nA, Grades 1, 2, 3: The cancer has spread to the glands of the endocervix but not beyond the uterine body. Stage nB, Grade 1, 2, 3: The cancer has spread to the stroma of the cervix. Stage IllA, Grade 1, 2, 3: The cancer invades the serosa and/or adnexa and/or peritoneal cavity, and cytology examination is positive. Stage B, Grade 1, 2, 3: Cancer has spread to the vagina. Stage C, Grade 1, 2, 3: Cancer has invaded the pelvic and/or para-aortic lymph nodes. Stage WA, Grade 1, 2, 3: Cancer has invaded the bladder and/or intestinal mucosa. WB stage, grade 1, 2, 3: The cancer has metastasized to distant organs, such as the abdominal cavity and/or inguinal lymph nodes.

Symptoms of Endometrial Cancer

(1) Irregular bleeding Vaginal bleeding is the main symptom of endometrial cancer, usually with a small to moderate amount of bleeding. In young women or perimenopausal women, it is often mistaken for menstrual irregularities and ignored. In postmenopausal women, it often presents as continuous or intermittent vaginal bleeding. Some patients only present with a small amount of bloody vaginal discharge after menopause. In late-stage patients, bleeding may be mixed with rotten meat-like tissue.

(2) Vaginal discharge Some patients have varying degrees of vaginal discharge. In the early stage, it may manifest as a thin white secretion or a small amount of bloody leucorrhea. If it is accompanied by infection or necrosis of the cancerous foci, there may be purulent secretions with a peculiar smell. Sometimes there is tissue in the vaginal discharge.

(3) Painful cancer and the bleeding or infection it causes can stimulate uterine contractions and cause paroxysmal lower abdominal pain. Postmenopausal women have poor drainage of uterine secretions due to cervical stenosis, and secondary infection leads to uterine cavity pyometra. Patients may experience severe lower abdominal pain and fever. In the late stage of the tumor, when the cancer tissue infiltrates through the entire layer of the uterus, or invades the parauterine connective tissue, paracervical ligaments, bladder, intestinal tract, or infiltrates and compresses the pelvic wall tissue or nerves, it can cause persistent, gradually increasing pain, which may be accompanied by lumbar pain or radiate to the ipsilateral lower limb.

(4) Abdominal mass: In the early stage of endometrial cancer, abdominal mass cannot usually be felt. If endometrial cancer is combined with a large uterine fibroid, or if pyometra occurs in the late stage and metastasizes to the pelvic and abdominal cavity to form a huge mass (such as ovarian metastasis), a mass may be felt in the abdomen. It is usually solid, has poor mobility, and is sometimes tender.

(5) In the late stage of other tumors, infiltration and compression of the iliac blood vessels can cause edema and pain in the ipsilateral lower limb; infiltration and compression of the ureter by the lesions can cause hydronephrosis of the ipsilateral renal pelvis and ureter, and even lead to renal atrophy; persistent bleeding can lead to secondary anemia; long-term tumor consumption can lead to systemic failure symptoms such as weight loss, fever, and cachexia.