The prevalence of the process

After the examination, you can determine the degree of prevalence of the tumor. However, the exact stage in most cases can only be determined after surgery and after microscopic examination by pathologists of the sample material.

The spread of the tumor in the body is an important criterion in choosing the best treatment for the patient. For a more accurate description, depending on the prevalence of the process, tumors are divided into stages.

Classification is carried out according to certain standards, for which, first of all, three aspects are decisive:

1. Tumor size (T)

2. Involvement in the process of lymph nodes (N)

3. Presence of distant metastases (M)

Therefore, the term "TNM classification" is also used. The numbers after the letter give an accurate idea of the size and extent of the tumor (T1-4), the number and location of affected lymph nodes (N0-3), and the presence or absence of distant metastases (M0 and M1). T1 N0 M0 would mean in this case that we are talking about a small tumor without the presence of affected lymph nodes and distant metastases. An accurate assessment of the TNM stage is possible only after surgical removal of the tumor.

Along with the TNM system for cancers of the female organs, there is a further classification of stages, the so-called "FIGO classification". It also takes into account the local spread of the tumor, the involvement of neighboring organs and lymph nodes in the process, as well as metastases to distant organs.

The next important criterion for planning uterine cancer treatment in Germany is the upward trend, i.e. the degree of malignancy of the cancerous tissue (Grading). This is determined during microscopy, during a biopsy of tissues taken for examination, i.e., a preparation of the uterus after its removal.

The G1 grade means that the tumor cells have much in common with the healthy cells from which the tumor originates, and therefore, most likely, are characterized by slow growth. The G3 grade indicates that the tumor cells bear very little resemblance to the healthy cells from which the tumor originates and are likely to grow very rapidly.

In addition, it may be important for further therapy whether hormone receptors are present on tumor cells. Many uterine carcinomas are estrogen-dependent (so-called "type I"). Hormonally independent tumors that do not respond to the female hormone estrogen are called "type II". Typical type II tumors are the so-called serous or clear cell carcinomas.

In case of late detected tumors of the uterus, which are already far advanced during the initial treatment, relapses may occur more often over time than with tumors found in the early stages. This means that the tumor, depending on the type of previous treatment, may reoccur in the uterus, as well as in other areas of the body (relapse).