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Cervical Cancer Staging

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Cervical Cancer Staging

Author: Cecelia H Boardman, MD; Chief Editor: Jules E Harris, MD more... Updated: May 20, 2011

TNM and FIGO Classifications for Cervical Cancer

The American Joint Committee on Cancer (AJCC) TNM classification and the International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer are provided below.[1, 2, 3] Table. TNM and FIGO Classifications for Cervical Cancer (Open Table in a new window) Primary tumor (T) TNM TX T0 Tis T1 T1a I IA FIGO Surgical-Pathologic Findings Primary tumor cannot be assessed No evidence of primary tumor Carcinoma in situ (preinvasive carcinoma) Cervical carcinoma confined to the cervix (disregard extension to the corpus) Invasive carcinoma diagnosed only by microscopy; stromal invasion with a maximum depth of 5.0 mm measured from the base of the epithelium and a horizontal spread of 7.0 mm or less; vascular space involvement, venous or lymphatic, does not affect classification Measured stromal invasion 3.0 mm in depth and 7.0 mm in horizontal spread Measured stromal invasion > 3.0 mm and 5.0 mm with a horizontal spread 7.0 mm Clinically visible lesion confined to the cervix or microscopic lesion greater than T1a/IA2 Clinically visible lesion 4.0 cm in greatest dimension Clinically visible lesion > 4.0 cm in greatest dimension Cervical carcinoma invades beyond uterus but not to pelvic wall or to lower third of vagina Tumor without parametrial invasion Clinically visible lesion 4.0 cm in greatest dimension Clinically visible lesion > 4.0 cm in greatest dimension Tumor with parametrial invasion Tumor extends to pelvic wall and/or involves lower third of vagina and/or causes
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Categories Stages

T1a1 T1a2 T1b T1b1 T1b2 T2 T2a T2a1 T2a2 T2b T3

IA1 IA2 IB IB1 IB2 II IIA IIA1 IIA2 IIB III

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Cervical Cancer Staging

hydronephrosis or nonfunctional kidney T3a T3b T4 T4a T4b NX N0 N1 M0 M1 IIIA IIIB IV IVA IVB Tumor involves lower third of vagina, no extension to pelvic wall Tumor extends to pelvic wall and/or causes hydronephrosis or nonfunctional kidney Tumor invades mucosa of bladder or rectum and/or extends beyond true pelvis (bullous edema is not sufficient to classify a tumor as T4) Tumor invades mucosa of bladder or rectum (bullous edema is not sufficient to classify a tumor as T4) Tumor extends beyond true pelvis Regional lymph nodes (N) Regional lymph nodes cannot be assessed No regional lymph node metastasis Regional lymph node metastasis Distant metastasis (M) No distant metastasis Distant metastasis (including peritoneal spread; involvement of supraclavicular, mediastinal, or para-aortic lymph nodes; and lung, liver, or bone)

Contributor Information and Disclosures

Author Cecelia H Boardman, MD The Dianne Harris Wright Professorship for Obstetrics and Gynecology Oncology Research, Virginia Commonwealth University Medical Center; Associate Professor (Collateral), Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Virginia Commonwealth University School of Medicine Cecelia H Boardman, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, American College of Surgeons, Minnesota Medical Association, and Society of Gynecologist Oncologists Disclosure: Merck Salary Speaking and teaching; Glaxo Salary Speaking and teaching; Depuy Salary Speaking and teaching Coauthor(s) Kirk J Matthews Jr, MD Resident Physician, Department of Obstetrics and Gynecology, Virginia Commonwealth University Medical Center Disclosure: Nothing to disclose. Specialty Editor Board Jasmeet Anand, PharmD, RPh Adjunct Instructor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Nothing to disclose. Christopher D Braden, DO Hematologist/Oncologist, Chancellor Center for Oncology at Deaconess Hospital; Hematologist/Oncologist, St Francis Hospital System Cancer Center Disclosure: Nothing to disclose. Chief Editor Jules E Harris, MD Clinical Professor of Medicine, Division of Hematology/Medical Oncology, Department of Internal Medicine, University of Arizona College of Medicine; Consulting Staff, Arizona Cancer Center Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Society of Hematology, and Central Society for Clinical Research
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Cervical Cancer Staging

Disclosure: GlobeImmune Salary Consulting

References
1. Pecorelli S, Zigliani L, Odicino F. Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet. May 2009;105(2):107-8. [Medline]. 2. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynaecol Obstet. May 2009;105(2):103-4. [Medline]. 3. NCCN Clinical Practice Guidelines in Oncology: Melanoma. V 1. 2011;Accessed March 28, 2011. Available at http://www.nccn.org/professionals/physician_gls/pdf/cervical.pdf. Medscape Reference 2011 WebMD, LLC

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