Stage Information for Cervical Cancer
Note: The American Joint Committee on Cancer has recently published a new edition of the AJCC Cancer Staging Manual, which includes revisions to the staging for this disease. The PDQ Adult Treatment Editorial Board, which is responsible for maintaining this summary, is currently reviewing the new staging to determine the changes that need to be made in the summary. In addition to updating this Stage Information section, additional changes may need to be made to other parts of this summary to ensure that it is up-to-date. The changes will be made as soon as possible.
Cervical carcinoma has its origins at the squamous-columnar junction whether in the endocervical canal or on the portion of the cervix. The precursor lesion is dysplasia or carcinoma in situ (cervical intraepithelial neoplasia [CIN]), which can subsequently become invasive cancer. This process can be quite slow. Longitudinal studies have shown that in untreated patients with in situ cervical cancer, 30% to 70% will develop invasive carcinoma over a period of 10 to 12 years. However, in about 10% of patients, lesions can progress from in situ to invasive in a period of less than 1 year. As it becomes invasive, the tumor breaks through the basement membrane and invades the cervical stroma. Extension of the tumor in the cervix may ultimately manifest as ulceration, exophytic tumor, or extensive infiltration of underlying tissue including bladder or rectum.
Understanding Cervical Cancer -- Symptoms
In the early stages, cervical precancers or cervical cancers cause no pain or other symptoms. That's why it's vital for women to get regular pelvic exams and Pap tests to detect cancer in its earliest stage when it's treatable. The first identifiable symptoms of cervical cancer are likely to include: Abnormal vaginal bleeding, such as after intercourse, between menstrual periods, or after menopause; menstrual periods may be heavier and last longer than normal. Pain during intercourse. ...
Read the Understanding Cervical Cancer -- Symptoms article > >
In addition to local invasion, carcinoma of the cervix can spread via the regional lymphatics or bloodstream. Tumor dissemination is generally a function of the extent and invasiveness of the local lesion. While cancer of the cervix generally progresses in an orderly manner, occasionally a small tumor with distant metastasis is seen. For this reason, patients must be carefully evaluated for metastatic disease.
Pretreatment surgical staging is the most accurate method to determine the extent of disease.[1] Because there is little evidence to demonstrate overall improved survival with routine surgical staging, the staging usually should be performed only as part of a clinical trial. Pretreatment surgical staging in bulky but locally curable disease may be indicated in select cases when a nonsurgical search for metastatic disease is negative. If abnormal nodes are detected by computed tomography scan or lymphangiography, fine-needle aspiration should be negative before a surgical staging procedure is performed.
Stages are defined by the Federation Internationale de Gynecologie et d'Obstetrique (FIGO) or the American Joint Committee on Cancer's (AJCC) TNM classification.[2,3,4]
TNM Definitions
The definitions of the T categories correspond to the several stages accepted by the FIGO.
FIGO Staging
Stage I
Stage I is carcinoma strictly confined to the cervix; extension to the uterine corpus should be disregarded.
- Stage IA: Invasive cancer identified only microscopically. All gross lesions even with superficial invasion are stage IB cancers. Invasion is limited to measured stromal invasion with a maximum depth of 5 mm* and no wider than 7 mm.*The depth of invasion should be 5 mm or less taken from the base of the epithelium, either surface or glandular, from which it originates. Vascular space involvement, either venous or lymphatic, should not alter the staging.
- Stage IA1: Measured invasion of the stroma 3 mm or less in depth and 7 mm or less in diameter.
- Stage IA2: Measured invasion of stroma more than 3 mm but 5 mm or less in depth and 7 mm or less in diameter.
- Stage IB: Clinical lesions confined to the cervix or preclinical lesions greater than stage IA.
- Stage IB1: Clinical lesions 4 cm or less in size.
- Stage IB2: Clinical lesions more than 4 cm in size.
WebMD Public Information from the National Cancer Institute
Today in Cervical Cancer
Health Solutions From Our Sponsors
©2005-2012 WebMD, LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment. See additional information.