Stage Information for Vaginal Cancer
If the cervix is intact, biopsies are mandatory to rule out a primary carcinoma of the cervix. Carcinoma of the vulva should also be ruled out.
The Féderation Internationale de Gynécologie et d'Obstétrique (FIGO) and the American Joint Committee on Cancer (AJCC) have designated staging to define vaginal cancer; the FIGO system is most commonly used.[1,2] The definitions of the AJCC's T, N, and M categories correspond to the stages accepted by FIGO.
FIGO staging system (and modified World Health Organization [WHO] prognostic scoring system)
The FIGO staging system is as follows:
Table 1. Carcinoma of the Vaginaa
|FIGO = Féderation Internationale de Gynécologie et d'Obstétrique.
a Adapted from FIGO Committee on Gynecologic Oncology.
||The carcinoma is limited to the vaginal wall.
||The carcinoma has involved the subvaginal tissue but has not extended to the pelvic wall.
||The carcinoma has extended to the pelvic wall.
||The carcinoma has extended beyond the true pelvis or has involved the mucosa of the bladder or rectum; bullous edemas as such does not permit a case to be allotted to stage IV.
|IVa - Tumor invades bladder and/or rectal mucosa and/or direct extension beyond the true pelvis.
|IVb - Spread to distant organs.
In addition, the FIGO staging system incorporates a modified WHO prognostic scoring system. The scores from the eight risk factors are summed and incorporated into the FIGO stage, separated by a colon (e.g., Stage II:4, Stage IV:9, etc.). Unfortunately, a variety of risk scoring systems have been published, making comparisons of results difficult.
FIGO Committee on Gynecologic Oncology.: Current FIGO staging for cancer of the vagina, fallopian tube, ovary, and gestational trophoblastic neoplasia. Int J Gynaecol Obstet 105 (1): 3-4, 2009.
Vagina. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 387-9.