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Stage Information for Cervical Cancer

(continued)

continued...

Table 2. Regional Lymph Nodes (N)a

FIGO = F�deration Internationale de Gyn�cologie et d'Obst�trique.
^a Reprinted with permission from AJCC: Cervix uteri. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 395-402.
TNM Categories	FIGO Stages	�
NX	�	Regional lymph nodes cannot be assessed.
N0	No regional lymph node metastasis.
N1	IIIB	Regional lymph node metastasis.

Table 3. Distant Metastasis (M)a

FIGO = F�deration Internationale de Gyn�cologie et d'Obst�trique.
^a Reprinted with permission from AJCC: Cervix uteri. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 395-402.
TNM Categories	FIGO Stages	�
M0	�	No distant metastasis.
M1	IVB	Distant metastasis (including peritoneal spread, involvement of supraclavicular, mediastinal, or para-aortic lymph nodes, lung, liver, or bone).

Table 4. Anatomic Stage/Prognostic Groups (FIGO 2008)a

FIGO = F�deration Internationale de Gyn�cologie et d'Obst�trique.
^a Reprinted with permission from AJCC: Cervix uteri. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 395-402.
^b FIGO no longer includes stage 0 (Tis).
Stage	T	N	M
0^b	Tis	N0	M0
I	T1	N0	M0
IA	T1a	N0	M0
IA1	T1a1	N0	M0
IA2	T1a2	N0	M0
IB	T1b	N0	M0
IB1	T1b1	N0	M0
IB2	T1b2	N0	M0
II	T2	N0	M0
IIA	T2a	N0	M0
IIA1	T2a1	N0	M0
IIA2	T2a2	N0	M0
IIB	T2b	N0	M0
III	T3	N0	M0
IIIA	T3a	N0	M0
IIIB	T3b	Any N	M0
T1-3	N1	M0
IVA	T4	Any N	M0
IVB	Any T	Any N	M1

Table 5. Carcinoma of the Cervix Uteria

^a Adapted from FIGO Committee on Gynecologic Oncology.[3]
^b All macroscopically visible lesions-even with superficial invasion-are allotted to stage IB carcinomas. Invasion is limited to a measured stromal invasion with a maximal depth of 5.00 mm and a horizontal extension of not >7.00 mm. Depth of invasion should not be >5.00 mm taken from the base of the epithelium of the original tissue-superficial or glandular. The depth of invasion should always be reported in mm, even in those cases with "early (minimal) stromal invasion" (~1 mm).
The involvement of vascular/lymphatic spaces should not change the stage allotment.
^c On rectal examination, there is no cancer-free space between the tumor and the pelvic wall. All cases with hydronephrosis or nonfunctioning kidney are included, unless they are known to be the result of another cause.
Stage	�
I	The carcinoma is strictly confined to the cervix (extension to the corpus would be disregarded).
IA	Invasive carcinoma, which can be diagnosed only by microscopy with deepest invasion ?5 mm and largest extension ?7 mm.
IA1	Measured stromal invasion of ?3.0 mm in depth and extension of ?7.0 mm.
IA2	Measured stromal invasion of >3.0 mm and not >5.0 mm with an extension of not >7.0 mm.
IB	Clinically visible lesions limited to the cervix uteri or preclinical cancers greater than stage IA.^b
IB1	Clinically visible lesion ?4.0 cm in greatest dimension.
IB2	Clinically visible lesion >4.0 cm in greatest dimension.
II	Cervical carcinoma invades beyond the uterus but not to the pelvic wall or to the lower third of the vagina.
IIA	Without parametrial invasion.
IIA1	Clinically visible lesion ?4.0 cm in greatest dimension.
IIA2	Clinically visible lesion >4.0 cm in greatest dimension.
IIB	With obvious parametrial invasion.
III	The tumor extends to the pelvic wall and/or involves lower third of the vagina and/or causes hydronephrosis or nonfunctioning kidney.^c
IIIA	Tumor involves lower third of the vagina with no extension to the pelvic wall.
IIIB	Extension to the pelvic wall and/or hydronephrosis or nonfunctioning kidney.
IV	The carcinoma has extended beyond the true pelvis or has involved (biopsy proven) the mucosa of the bladder or rectum. A bullous edema, as such, does not permit a case to be allotted to stage IV.
IVA	Spread of the growth to adjacent organs.
IVB	Spread to distant organs.

References:

Gold MA, Tian C, Whitney CW, et al.: Surgical versus radiographic determination of para-aortic lymph node metastases before chemoradiation for locally advanced cervical carcinoma: a Gynecologic Oncology Group Study. Cancer 112 (9): 1954-63, 2008.
Cervix uteri. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 395-402.
Pecorelli S: Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet 105 (2): 103-4, 2009.

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Last Updated: May 16, 2012

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