UTERUS ENDOMETRIUM (ICD‐O‐3 C54.0, 1, 3, 8, 9, C55)
The definitions of the T, N, and M categories correspond to the FIGO stages. Both systems are included for comparison.
Rules for Classification
The classification applies to endometrial carcinomas and carcinosarcomas (malignant mixed mesodermal tumours). There should be histological verification with subdivision by histological type and grading of the carcinomas. The diagnosis should be based on examination of specimens taken by endometrial biopsy.
The FIGO stages are based on surgical staging. TNM stages are based on clinical and/or pathological classification.
Anatomical Subsites (Fig. 424)
- Isthmus uteri (C54.0)
- Fundus uteri (C54.3)
- Endometrium (C54.1)
Regional Lymph Nodes (Fig. 425)
The regional lymph nodes are the pelvic (hypogastric [obturator, internal iliac] (3), common (5) and external (4) iliac, parametrial (2), and sacral (6)) and the para‐aortic nodes (7).
TNM Clinical Classification
T – Primary Tumour
TNMCategories | FIGO Stages | Definition |
TX | Primary tumour cannot be assessed | |
T0 | No evidence of primary tumour | |
T1 | I* | Tumour confined to the corpus uteri1 (Fig. 437) |
T1a | IA* | Tumour limited to the endometrium or invading less than half of myometrium |
T1b | IB | Tumour invades one half or more of myometrium |
T2 | II | Tumour invades cervical stroma, but does not extend beyond the uterus2 (Fig. 438) |
T3 | III | Local and/or regional spread as specified below |
T3a | IIIA | Tumour invades the serosa of the corpus uteri or adnexae (direct extension or metastasis) (Fig. 439) |
T3b | IIIB | Vaginal or parametrial involvement (direct extension or metastasis) (Fig. 439) |
N1 | IIIC | Metastasis to pelvic or para‐aortic lymph nodes (Fig. 441) |
IIIC1 | Metastasis to pelvic lymph nodes | |
IIIC2 | Metastasis to para‐aortic lymph nodes with or without metastasis to pelvic lymph nodes | |
T4M1 | IVAIVB | Tumour invades bladder/bowel mucosa3 (Fig. 440)Distant metastasis |
Notes1Endocervical glandular involvement only should now be considered as stage I.
2Positive cytology has to be reported separately without changing the stage.
3The presence of bullous oedema is not sufficient evidence to classify as T4.





N – Regional Lymph Nodes
NX | Regional lymph nodes cannot be assessed |
N0 | No regional lymph node metastasis |
N1 | Pelvic lymph node metastasis |
N2 | Para‐aortic lymph node metastasis |
M – Distant Metastasis
M0 | No distant metastasis |
M1 | Distant metastasis (excluding metastasis to vagina, pelvic serosa, or adnexa, including metastasis to inguinal lymph nodes, intra‐abdominal lymph nodes other than para‐aortic or pelvic nodes) |
pTNM Pathological Classification
The pT and pN categories correspond to the T and N categories.
pM1 | Distant metastasis microscopically confirmed |
NotepM0 and pMX are not valid categories.
pN0 | Histological examination of a pelvic lymphadenectomy specimen will ordinarily include 6 or more lymph nodes. If the lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0. |
Summary

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