Endometrial Staging

Endometrial Staging (2023)

Molecular & Pathology Integrated

Confined to Corpus

IA (≤50% Myometrium) | IB (>50% Myometrium) | IC (Integrated Molecular Stage)

Cervical Stroma Involved

Does NOT extend beyond uterus

III

Local / Regional Spread

IIIA (Serosa/Adnexa) | IIIB (Vagina/Parametrium) | IIIC (Lymph Nodes)

Bladder / Rectum / Distant

IVA (Bowel/Bladder Mucosa) | IVB (Distant Metastasis)

Molecular update: Stage I includes POLE mutations (favorable) and p53 mutations (unfavorable).

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Primary Clinical Uses

Surgical and pathological staging of endometrial carcinoma and carcinosarcoma

Directing postoperative adjuvant treatment (radiation vs chemotherapy)

The 2023 Molecular Revolution

The 2023 update was the most radical change in history. It officially incorporated molecular classification (POLEmut, MMRd, NSMP, p53abn) into the staging system. A p53-abnormal tumor is now heavily upstaged regardless of myometrial invasion, whereas a POLE-mutated tumor may be downstaged due to exceptional prognosis.

How it Works

Stage I — Confined to Uterus (Ovary involvement nuanced)

IA1	Non-aggressive histology, confined to endometrium/polyp
IA2	Non-aggressive histology, <50% myometrial invasion
IA3	Low-grade endometrioid tracking to ovaries (new criteria)
IB	Non-aggressive histology, ≥50% myometrial invasion
IC	Aggressive histology (e.g., serous, clear cell), ANY myometrial invasion

Stage II — Cervical Stroma or Extrauterine extensions

IIA	Invasion of cervical stroma
IIB	Substantial lymphovascular space invasion (LVSI)
IIC	Aggressive histology with cervical stromal invasion

Stage III — Local/Regional Spread

IIIA	Invasion of serosa, adnexa (non-Grade 1 endometrioid)
IIIB	Vaginal or parametrial involvement
IIIC1	Pelvic lymph node involvement (micro or macro)
IIIC2	Para-aortic lymph node involvement

Stage IV — Distant Spread

IVA	Invasion of bladder/bowel mucosa
IVB	Distant metastasis, including intra-abdominal or inguinal nodes

Last Comprehensive Review: 2026-07-17

In Recent Clinical News

Scanning Medical Journals

No new significant updates or guidelines matching this topic were found today. We will check again soon.

Endometrial Staging