When endometrial cancer is diagnosed, it is usually confined to the uterus with 80% in stage I.
Metastasis occurs primarily by direct invasion of the uterine wall and down to the cervix and further to the parametria or the abdominal cavity. Vaginal spreading also occurs, and tumor cells can spread to the abdominal cavity via the fallopian tubes. Further metastasis can occur lymphogen to lymph nodes on the pelvic wall and/or paraaortic, as well as via blood to the lungs and liver.
Serous-papillary and clear cell tumors have a great tendency to spread to the abdominal cavity in the same way as ovarian cancer, as well as a great tendency for spread to lymph nodes.
Carcinosarcomas have great tendency to spread to lymph nodes.