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: 61,880 (2019 U.S. estimate) 27.5 per 100,000 women per year Deaths: 12,160 (2019 U.S. estimate) Median age at diagnosis: 63 years Siegel RL et al. CA Cancer J Clin 2019;69:7–34 Surveillance, Epidemiology and End Results (SEER) Program, available from http://seer.cancer.gov [accessed December 12, 2019] ++ Pathology Table Graphic Jump Location|Download (.pdf)|Print Pathology Endometrioid 75–80% Serous ~10% Clear cell <5% Mucinous 1% Squamous <1% Mixed 10% Carcinosarcoma <5% Rare subtypes: Neuroendocrine carcinoma Dedifferentiated carcinoma <1% WHO Classification of tumors of the female reproductive organs (Kurman, Carcangiu, Herrington, Young (Eds). World Health Organization, 2014 ++ Diagnosis Table Graphic Jump Location|Download (.pdf)|Print Diagnosis Abnormal uterine bleeding Endometrial curettage Endometrial biopsy No abnormal uterine bleeding, but other symptoms present✫ Endometrial curettage and biopsy Consider biopsy if distant disease suspected ✫Patients may present with nonspecific symptoms, including abdominal bloating, pain, or distention as well as constitutional symptoms ++ Staging and treatment evaluation Table Graphic Jump Location|Download (.pdf)|Print Staging and treatment evaluation All Patients Physical exam, including pelvic examination Assessment of hereditary risk CBC with platelet count Chemistry panel Consider CA–125 measurement High-risk histologies (serous or clear cell cancer), suspected advanced disease, or confirmed stages III/IV CT chest/abdomen/pelvis, MRI pelvis, or other imaging (eg, PET scan) ++ Staging Table Graphic Jump Location|Download (.pdf)|Print Staging Staging outlined below is for uterine carcinomas and carcinosarcomas only. FIGO Stage TNM Primary Tumor (T) TX Primary tumor cannot be assessed T0 No evidence of primary tumor I T1 Tumor confined to corpus uteri (includes endocervical gland involvement) IA T1a Tumor limited to endometrium or invades less than one-half of the myometrium IB T1b Tumor invades one-half or more of the myometrium II T2 Tumor invades stromal connective tissue of the cervix but does not extend beyond uterus. Does NOT include endocervical glandular involvement III T3 Tumor involves serosa, adnexa, vagina, or parametrium IIIA T3a Tumor involves serosa and/or adnexa (direct extension or metastasis) IIIB T3b Vaginal involvement (direct extension or metastasis) or parametrial involvement IVA T4 Tumor invades bladder mucosa and/or bowel mucosa (bullous edema is not sufficient to classify a tumor as T4) Table Graphic Jump Location|Download (.pdf)|Print Staging FIGO Stage TNM Category Regional Lymph Nodes (N) NX Regional lymph nodes cannot be assessed N0 No regional lymph node metastasis N0 (i+) Isolated tumor cells in regional lymph node(s) ≤0.2 mm IIIC1 N1 Regional lymph node metastasis to pelvic lymph nodes IIIC1 N1mi Regional lymph node metastasis (>0.2 mm but ≤2.0 mm in diameter) to pelvic lymph nodes IIIC1 N1a Regional lymph node metastasis (>2.0 mm in diameter) to pelvic lymph nodes IIIC2 N2 Regional lymph node metastasis to para-aortic lymph nodes, with or without positive pelvic lymph nodes IIIC2 N2mi Regional ... 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 Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth