Uterine Sarcoma: Grades and Stages

What does stage of cancer mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. He or she can also see if the cancer has grown into nearby areas, and if it has spread to other parts of your body. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.

What does the grade of cancer mean?

The grade refers to how the cancer cells look when compared to normal uterine cells. The grade of your cancer will help your doctor predict how fast the cancer may grow and spread.

A scale of 1 to 4 is used to grade uterine sarcoma. The lower the number, the more the cancer cells look like normal cells. This means the cancer is less likely to spread, and may be easier to treat and cure. This is because cancer cells that look more like normal cells tend to grow and spread slowly. Grade 4 cancer cells look very different from normal cells. This grade of cancer is more likely to spread.

The systems of staging uterine sarcoma

Doctors may use different systems to stage cancer. There are 2 systems used most often to stage uterine sarcoma:

• FIGO staging system

• TNM staging system

The two systems are the same. Both use the TNM system:

• T stands for tumor. This category notes details about the tumor itself, such as size and location.

• N stands for nodes. Lymph nodes are small organs around the body. They help the body fight infections. This category notes if cancer cells have spread to the nearby lymph nodes.

• M stands for metastasis. This category notes if the cancer has spread to distant lymph nodes, other organs, or bones.

Numbers or letters after T, N, and M provide more details about each of these factors. There are also 2 other values that can be assigned:

• X means the provider does not have enough information to assess the extent of the main tumor (TX), or if the lymph nodes have cancer cells in them (NX).

• 0 means no sign of cancer, such as no sign of the primary (main) tumor (T0).

Stage groupings are determined by combining the T, N, and M values from the TNM system. These groupings give an overall description of your cancer. A stage grouping can have a value of 1 to 4 and they're written as Roman numerals I, II, II, and IV. The higher the number, the more advanced the cancer is. Letters and numbers can be used after the Roman numeral to give more details.

Stages of uterine sarcoma 

These are the stage groupings of uterine sarcoma and what they mean:

Stage I

The cancer is only in the uterus. This stage is divided into 2 subgroups: 

• Stage IA. The cancer is no more than 5 cm (centimeters) across. 

• Stage IB. The cancer is more than 5 cm across.

Stage II

The cancer has grown outside the uterus, but not outside the pelvis. It has not spread to nearby lymph nodes or to organs in othe parts of the body.

Stage III

The cancer has spread beyond the uterus, but it has not spread to distant parts of the body. This stage is further divided into these 3 subgroups:

• Stage IIIA. The cancer is growing into belly (abdominal) tissues in only one place. It's not in nearby lymph nodes. 

• Stage IIIB. The cancer is growing into abdominal tissues in 2 or more places. It's not in nearby lymph nodes. 

• Stage IIIC. The cancer is growing in the uterus and may or may not have spread into tissues of the abdomen. It has not spread to the bladder or rectum. It has spread to lymph nodes near the uterus.

Stage IV

This stage is divided into these 2 subgroups: 

• Stage IVA. The cancer has spread to the bladder or the rectum. It may or may not have spread to nearby lymph nodes. It has not spread to distant organs in other parts of the body.

• Stage IVB. The cancer may or may not have grown into tissues in the abdomen or pelvis, such as the bladder or rectum. It may or may not have spread to lymph nodes near the uterus. It has spread to organs that are not next to the uterus, such as the liver, bones, or lungs. Or it has spread to distant lymph nodes.

Talking with your healthcare provider

When your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand. Make sure to ask any questions or talk about your concerns.