Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ INTRODUCTION ++ Epidemiology Table Graphic Jump Location|Download (.pdf)|Print Epidemiology Incidence: 52,630 (Estimated new cases for 2014 in the United States) Stage at Presentation Localized: 72% Stage I: 79% 24.3 per 100,000 women per year. Regional: 16% Stage II: 12.5% Deaths: Estimated 8,590 in 2014 Distant: 8% Stage III: 13.3% Median age at diagnosis: 62 years Unstaged: 4% Stage IV: 4% Modified from Creasman WT et al. J Epidemiol Biostat 2001;6:47–86 Siegel R et al. CA Cancer J Clin 2014;64:9–29 Surveillance, Epidemiology and End Results (SEER) Program, available from http://seer.cancer.gov (accessed in 2013) ++ Pathology Table Graphic Jump Location|Download (.pdf)|Print Pathology Endometrioid Ciliated adenocarcinoma Secretory adenocarcinoma Adenocarcinoma with squamous differentiation–Adenosquamous 75–80% Serous <10% Clear cell 4% Mucinous 1% Squamous <1% Mixed 10% Undifferentiated Kurman RJ, Ellenson LH, Ronnett BM editors. Blaustein's Pathology of the Female Genital Tract. 6th ed: Springer; 2011 ++ Work-up Table Graphic Jump Location|Download (.pdf)|Print Work-up Stage I H&P CBC with platelet count Chest x-ray Cervical cytology Stage II Consider endocervical curettage or cervical biopsy Stages III/IV CA-125 MRI/CT as clinically indicated ++ Staging Table Graphic Jump Location|Download (.pdf)|Print Staging TNM Category FIGO Stage✫ Primary Tumor (T) TX Primary tumor cannot be assessed T0 No evidence of primary tumor Tis Carcinoma in situ (preinvasive carcinoma) T1 I Tumor confined to corpus uteri T1a IA Tumor limited to endometrium or invades less than one-half of the myometrium T1b IB Tumor invades one-half or more of the myometrium T2 II Tumor invades stromal connective tissue of the cervix but does not extend beyond uterus† T3a IIIA Tumor involves serosa and/or adnexa (direct extension or metastasis) T3b IIIB Vaginal involvement (direct extension or metastasis) or parametrial involvement T4 IVA Tumor invades bladder mucosa and/or bowel mucosa (bullous edema is not sufficient to classify a tumor as T4) ✫FIGO staging no longer includes stage 0 (Tis) †Endocervical glandular involvement only should be considered as stage I and not stage II Table Graphic Jump Location|Download (.pdf)|Print Staging TNM Category FIGO Stage Regional Lymph Nodes (N) NX Regional lymph nodes cannot be assessed N0 No regional lymph node metastasis N1 IIIC1 Regional lymph node metastasis to pelvic lymph nodes N2 IIIC2 Regional lymph node metastasis to para-aortic lymph nodes, with or without positive pelvic lymph nodes Table Graphic Jump Location|Download (.pdf)|Print Staging TNM Category FIGO Stage Distant Metastasis (M) M0 No distant metastasis (no pathologic M0; use clinical M to complete stage group) MI IVB Distant metastasis (includes metastasis to inguinal lymph nodes intraperitoneal disease, or lung, liver, or bone. It excludes metastasis to paraaortic lymph nodes, vagina, pelvic serosa, or adnexa) Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, eds. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer; ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth