Uterine Sarcoma: Grades and Stages

What does the grade of cancer mean?

The grade refers to how much the uterine cancer cells look like normal uterine cells. The grade of your cancer will help your healthcare provider predict how fast the cancer may grow and spread.

A scale of 1 to 3 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 it may be easier to treat. Grade 3 cancer cells look very abnormal and very different from normal cells. This grade of cancer is more likely to spread.

What does the stage of cancer mean?

The stage of a cancer is how much there is and how far it has spread in your body. Your healthcare provider uses exams and imaging scans to find out the size of the cancer and where it is. They want to 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.

The systems of staging uterine sarcoma

Healthcare providers may use different systems to stage cancer. There are two systems used most often to stage uterine sarcoma:

  • FIGO staging system

  • TNM staging system

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

  • T stands for tumor. It gives details about the tumor itself, such as how big it is and where it is.

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

  • M stands for metastasis. It shows if the cancer has spread to the bones, lungs, liver, or other distant organs.

Numbers or letters after T, N, and M provide more details about each of these factors. There are also two 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), or no cancer has been found in the lymph nodes (N0).

Stage groupings are done 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. They're written as Roman numerals I, II, III, and IV. The higher the number, the more cancer there is. Letters and numbers can be used after the Roman numeral to give even more details.

Stages of uterine sarcoma 

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

Stage I

The cancer is only inside the uterus. This stage is divided into two 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 other 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 three subgroups:

  • Stage IIIA. The cancer is growing into belly (abdominal) tissues in only 1 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 two 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, like the liver, bones, brain, lungs, or distant lymph nodes.

Talking with your healthcare provider

Your healthcare provider will talk with you about what the grade and stage of your cancer means and how it affects your treatment choices. 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.