Metastatic endometrial cancer can affect distant areas of the body, such as the lungs, liver, bones, or brain. Treatments may include surgery alongside radiation therapy, chemotherapy, or other drugs.

Metastatic endometrial cancer is an advanced stage of cancer that has spread from the lining of the uterus to other areas of the body.

Symptoms of advanced endometrial cancer may include pelvic pain, a mass in the pelvis, and unexplained weight loss.

This article examines where metastatic endometrial cancer may spread, treatment options, and outlook.

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Metastatic endometrial cancer is cancer that begins in the endometrium, the lining of the uterus, and spreads to a distant part of the body.

Doctors stage endometrial cancer from 1 to 4, with higher numbers indicating the cancer has spread further from the original site.

Stage 4 cancer means it has spread to other areas of the body.

Learn more about the stages of cancer.

According to a 2019 analysis, the most common site for endometrial cancer to spread to is the lungs. After this, other common sites are distant lymph nodes, the liver, bones, and the brain.

According to a 2023 review article of 3,878 people with metastatic endometrial cancer, distant organ metastasis is rare. The article found that rates of distant organ metastasis were as follows:

  • Lung metastasis: 29.4%
  • Liver metastasis: 14.9%
  • Bone metastasis: 10.5%
  • Brain metastasis: 3.1%

Stage 4 endometrial cancer includes cancer that has spread to the following areas:

  • bladder
  • bowel
  • lymph nodes outside the pelvic area
  • omentum, which is part of the lining around the abdomen
  • lungs, liver, or other organs

Learn more about what happens when cancer spreads to the lymph nodes.

According to the American Cancer Society (ACS), some symptoms of endometrial cancer can be more common as the cancer progresses. People may notice the following:

  • atypical vaginal bleeding, such as spotting
  • atypical discharge
  • pelvic pain
  • feeling a mass in the pelvic area
  • unexplained weight loss

If cancer has spread to another part of the body, people may also experience symptoms relating to that part of the body, such as:

  • shortness of breath for lung metastasis
  • swollen abdomen or yellowing of the skin and eyes for liver metastasis
  • bone pain and fractures for bone metastasis
  • headache, dizziness, or seizures for brain metastasis

These symptoms can also occur with other health conditions, but it is always best to speak with a doctor as soon as possible if people notice any new or worsening symptoms.

Learn more about some of the symptoms of endometrial cancer.

Surgery is typically the first-line treatment for endometrial cancer. This includes a hysterectomy to remove the uterus, as well as removal of the fallopian tubes and ovaries. People may also have surgery to remove lymph nodes in the pelvic area.

In metastatic endometrial cancer, the cancer has usually spread too far for surgery to remove all of the cancer. People may still have surgery but will have other additional treatments to help destroy cancer cells. This may include:

Hormone therapy may be effective for some types of endometrial cancer, but certain types may not respond to this particular treatment. This may include high grade cancers and cancer cells with no detectable progesterone and estrogen receptors.

People may have a combination of some of the following chemotherapy drugs:

Targeted drugs and immunotherapy are also options for treating advanced stages of endometrial cancer.

People with metastatic endometrial cancer may also want to consider joining clinical trials that are testing new treatments.

Learn more about some common types of chemo drugs.

The outlook for metastatic endometrial cancer may depend on which part of the body the cancer has spread to. According to a 2020 report, the outlook may be poor for people with endometrial cancer that has spread to the brain or multiple organs.

A 2019 analysis found that endometrial cancer that spread only to the distant lymph nodes had the best overall survival, while cancer that spread to the brain had the worst outlook compared to other areas of metastasis.

According to a 2023 review article, in cases where endometrial cancer spread to one distant organ, the longest survival time occurred with lung metastasis, while the shortest survival occurred with brain metastasis.

Other factors that can affect a person’s outlook include age, overall health, and treatment response.

What is the survival rate for metastatic endometrial cancer?

According to the National Cancer Institute, the 5-year relative survival rate for endometrial cancer, which has spread to distant areas of the body, such as the lungs, liver, or bones, is 18.9%.

As medical research and treatments advance, outlook and survival rates for endometrial cancer may improve from previous reports.

Relative survival rates

The relative survival rate suggests how long someone with a condition may live after their diagnosis compared to someone without the condition of the same race, sex, and age over a specific time. This is different from the overall survival rate, which is the percentage of people still alive for a specific time after diagnosis of a condition.

It’s most important to remember that figures are estimates, and everyone is different. Talk with your doctor about your specific condition.

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What is the life expectancy of metastatic endometrial cancer?

Life expectancy can depend on:

  • the type of endometrial cancer a person has
  • where the cancer has spread to
  • the type of treatment they have.

A 2020 study looked at how surgery affected life expectancy in 730 people with metastatic endometrial cancer.

The average cancer-specific survival for people with lung metastasis was 23 months with surgery and 9 months without surgery.

For bone metastasis, survival was 19 months with surgery and 8 months without surgery, and for multiple organ metastasis, survival was 15 months with surgery and 4 months without surgery.

Life expectancy for brain metastasis was 6 months with or without surgery.

Learn more about cancer prognoses.

Where is the first place endometrial cancer spreads?

Endometrial cancer may first spread to areas surrounding the lining of the uterus. In stage 1 endometrial cancer, it may grow into the myometrium, which is the outer layer of the uterus.

What is the most aggressive endometrial cancer?

Low-grade type 1 endometrioid cancers are generally less aggressive, as they may stay within the uterus and may have a favorable outlook.

High-grade type 2 endometrioid and non-endometrioid cancers with TP53 gene mutations may spread and reach an advanced stage with a less favorable outlook.

How fast does endometrial cancer spread?

The type of endometrial cancer may affect how quickly it spreads. The most common form of endometrial cancer is type 1, which is slow-growing. Type 1 endometrial cancer does not usually spread outside the uterus.

Type 2 endometrial cancer grows more quickly and is more likely to spread outside the uterus to other areas of the body.

Metastatic endometrial cancer is cancer that starts in the lining of the uterus but has spread to distant areas of the body, such as the lungs, bones, or distant lymph nodes.

Treatment for metastatic cancer may include surgery alongside other treatments, such as radiation therapy, chemotherapy, hormone therapy, or other cancer drugs.

The outlook for metastatic endometrial cancer may depend on treatment, the subtype of endometrial cancer, and which area of the body it has spread to.