Endometrium cancers

Carcinoma of the endometrium click to access explanations in the original CAP template

Microscopic descriptions:

- Tumor histology and immunohistochemical studies:

- Histologic type (WHO 5e):
- Histologic grade:
+ Molecular Type:	+ MMR IHC :
	+ MSI test :
	+ p53 status :
	+ POLE status:

ProMisE Classification
1. POLE-mutated carcinoma
2. Mismatch repair-deficient carcinoma
3. p53-abnormal carcinoma
4. No specific molecular profile (NSMP)
5. Double classifier (explain):

TCGA Classification
1. POLE-mutated (ultramutated) carcinoma
2. Microsatellite instability high (hypermutated) carcinoma
3. Copy number low carcinoma
4. Copy number high carcinoma
5. Double classifier (explain):

- Myometrial invasion:
	- Depth of invasion (mm):
	- Myometrial thickness (mm):
	- Myometrial invasion (%):
+ Adenomyosis:
- Uterine serosa involvement:
+ Lower uterine segment involvement:
- Cervical involvement:
	+ Depth of Cervical Stroma Invasion:
	+ Cervical Stroma Thickness:
- Lymphatic and / or vascular invasion:
+ Perineural invasion:
+ Peritoneal/ascitic fluid:

- Other tissue/ organ involvement: Not applicable Not identified Right ovary Left ovary Ovary (side not specified) Right fallopian tube Left fallopian tube Fallopian tube (side not specified) Vagina Right parametrium Left parametrium Parametrium (side not specified) Pelvic wall Bladder wall without mucosal involvement Bladder wall with mucosal involvement Bowel wall without mucosal involvement Bowel wall with mucosal involvement Omentum Other organs/tissue (specify): Cannot be determined (explain):

Surgical margins of excision specimen:

- Ectocervical/vaginal cuff margin:
- Parametrial/paracervical margin:

Pelvic lymph nodes:

- Number of lymph nodes examined:
- Number of lymph nodes with macrometastasis (> 2 mm):
- Number of lymph nodes with micrometastasis (> 0.2 to 2 mm):
- Number of lymph nodes with isolated tumor cells (< or = 0.2 mm):
- Laterality of lymph nodes with tumor cells:
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:
- Extranodal extension:

Para-aortic lymph nodes:

- Number of lymph nodes examined:
- Number of lymph nodes with macrometastasis (> 2 mm):
- Number of lymph nodes with micrometastasis (> 0.2 to 2 mm):
- Number of lymph nodes with isolated tumor cells (< or = 0.2 mm):
- Laterality of lymph nodes with tumor cells:
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:
- Extranodal extension:

Distant Metastasis: Not applicable Not identified Inguinal lymph node(s): Omentum: Extrapelvic peritoneum: Lung (specify): Liver (specify): Bone (specify): Other (specify): Cannot be determined:

FIGO 2009 Staging / 2018 FIGO Cancer Report:

I: Tumor confined to the corpus uteri
IA: No or less than half myometrial invasion
IB: Invasion equal to or more than half of the myometrium
III: Local and / or regional spread of the tumor
IIIA: Tumor invades the serosa of the corpus uteri and / or adnexae
IIIB: Vaginal and / or parametrial involvement
IIIC: Metastases to pelvic and / or para-aortic lymph nodes
IIIC1: Positive pelvic nodes
IIIC2: Positive para-aortic nodes with or without positive pelvic lymph nodes
IV: Tumor invades bladder and / or bowel mucosa, and / or distant metastases
IVA: Tumor invasion of bladder and / or bowel mucosa

FIGO 2023 Staging for Cancer of the Endometrium:

I: Confined to the uterine corpus and ovary
IA: Disease limited to the endometrium OR non-aggressive histological type, i.e., low-grade endometrioid, with invasion of less than half of the myometrium with no or focal lymphovascular space involvement (LVSI) OR good prognosis disease
IA1: Non-aggressive histological type limited to an endometrial polyp OR confined to the endometrium
IA2: Non-aggressive histological types involving less than half of the myometrium with no or focal LVSI
IA3: Low-grade endometrioid carcinomas limited to the uterus and ovary
+IAm (POLEmut): POLE mutated endometrial carcinoma, confined to the uterine corpus or with cervical extension, regardless of the degree of LVSI or histological type
IB: Non-aggressive histological types with invasion of half or more of the myometrium, and with no or focal LVSI
IC: Aggressive histological types limited to a polyp or confined to the endometrium

II: Invasion of cervical stroma without extrauterine extension OR with substantial LVSI OR aggressive histological types with myometrial invasion
IIA: Invasion of the cervical stroma of non-aggressive histological types
IIB: Substantial LVSI of non-aggressive histological types
IIC: Aggressive histological types with any myometrial involvement
+IICm (p53abn): p53 abnormal endometrial carcinoma confined to the uterine corpus with any myometrial invasion, with or without cervical invasion, and regardless of the degree of LVSI or histological type

III: Local and / or regional spread of the tumor of any histological subtype
IIIA: Invasion of uterine serosa, adnexa, or both by direct extension or metastasis
IIIA1: Spread to ovary or fallopian tube (except when meeting stage IA3 criteria)
IIIA2: Involvement of uterine subserosa or spread through the uterine serosa
IIIB: Metastasis or direct spread to the vagina and / or to the parametria or pelvic peritoneum
IIIB1: Metastasis or direct spread to the vagina and / or the parametria
IIIB2: Metastasis to the pelvic peritoneum
IIIC: Metastasis to pelvic or para-aortic lymph nodes or both
IIIC1: Metastasis to the pelvic lymph nodes
IIIC1i: Micrometastasis (to pelvic nodes)
IIIC1ii: Macrometastasis (to pelvic nodes)
IIIC2: Metastasis to para-aortic lymph nodes up to the renal vessels, with or without metastasis to the pelvic lymph nodes
IIIC2i: Micrometastasis (to para-aortic lymph nodes up to the renal vessels, with or without metastasis to the pelvic nodes)
IIIC2ii: Macrometastasis (to para-aortic lymph nodes up to the renal vessels, with or without metastasis to the pelvic nodes)

IV: Spread to the bladder mucosa and / or intestinal mucosa and / or distant metastasis
IVA: Invasion of the bladder mucosa and / or intestine / bowel mucosa
IVB: Abdominal peritoneal metastasis beyond the pelvis
IVC: Distant metastasis, including metastasis to any extra- or intra-abdominal lymph nodes above the renal vessels, lungs, liver, brain or bone

+ Additional pathologic findings:

Atypical hyperplasia/endometrial intraepithelial neoplasia (EIN)

- Other (specify):

- Additional notes: