Endometrial staging assessment form

All fields marked * are mandatory.

Histology

Myometrial invasion

LVSI

Uterine serosa

Cx stromal invasion

Ovary

Tube

Vagina

Parametria

Peritoneum

Lymph node

No metastasis

Metastasis to pelvic node(s) only

Metastasis to pelvic node(s) only, >0.2 mm – 2 mm and/or >200 cells

Metastasis to pelvic node(s) only, >2mm

Metastasis to para-aortic node(s) up to renal vessels

Metastasis to para-aortic node(s) up to renal vessels, >0.2 mm – 2 mm and/or >200 cells

Metastasis to para-aortic node(s) up to renal vessels, >2mm

Metastasis to extra-abdominal node(s)

Bladder mucosa

Intestinal mucosa

Distant metastasis

Molecular profile (optional)

The fields below are used to determine molecular classification.

POLE mutation

MMR

p53