Radiation Oncology/Uterine Sarcoma/Staging

Uterine Sarcomas

Current Staging

AJCC 7th Edition (2009)

Corresponds to the updated FIGO staging (2009)

FIGO 2009 PMID 19135669 -- "FIGO staging for uterine sarcomas."

Note: This is a new staging classification for uterine sarcomas. Previously they were staged according to the system in use for other cancers of the uterine corpus (see: Endometrial staging)

Includes: leiomyosarcoma, endometrial stromal sarcoma, adenosarcoma

Carcinosarcoma (MMMT) should be staged as carcinoma

Leiomyosarcoma and Endometrial Stromal Sarcoma
Primary Tumor:

• T1 (I) - limited to the uterus
  • T1a (IA) - 5 cm or less
  • T1b (IB) - more than 5 cm
• T2 (II) - extends beyond uterus but within the pelvis
  • T2a (IIA) - involves adnexa
  • T2b (IIB) - involves other pelvic tissues
• T3 (III) - tumor infiltrates abdominal tissues (must infilitrate the tissues and not just protrude into the abdominal cavity)
  • T3a (IIIA) - one site
  • T3b (IIIB) - more than one site
• T4 (IVA) - invades bladder or rectum

Adenosarcoma
Primary Tumor:

• T1 (I) - limited to the uterus
  • T1a (IA) - limited to the endometrium/endocervix
  • T1b (IB) - invades ≤ 1/2 of the myometrium
  • T1c (IC) - invades more than 1/2 of the myometrium
• T2 (II) - extends beyond uterus but within the pelvis
  • T2a (IIA) - involves adnexa
  • T2b (IIB) - involves other pelvic tissues
• T3 (III) - tumor infiltrates abdominal tissues (must infilitrate the tissues and not just protrude into the abdominal cavity)
  • T3a (IIIA) - one site
  • T3b (IIIB) - more than one site
• T4 (IVA) - invades bladder or rectum

For All Sites
Regional Lymph Nodes: pelvic or para-aortic

• N0 - no
• N1 (IIIC) - yes

Distant Metastases:

• M0 - none
• M1 (IVB) - yes

Stage Grouping:

• Corresponds to FIGO stage (given above in parentheses)