Cervical cancer (staging)
Updates to Article Attributes
Body
was changed:
Staging of cervical cancer can either be based on the TNM or FIGO system.
Revised FIGO staging of cervical carcinoma 2009 8
- stage 0: cervical intraepithelial neoplasia (HSIL or CIN III)
-
stage I: confined to cervix
-
stage Ia: invasive carcinoma only diagnosed by microscopy.
- Ia1: stromal invasion <3 mm in depth and <7 mm in extension (microinvasive)
- Ia2: stromal invasion >3 mm depth and not >5 mm and extension <7 mm
-
stage Ib: clinically visible lesions limited to the cervix or pre-clinical cancers >stage 1a
- Ib1: clinically visible tumour <4 cm in greatest dimension
- Ib2: clinically visible tumour >4 cm in greatest dimension
-
stage Ia: invasive carcinoma only diagnosed by microscopy.
-
stage II: beyond cervix though not to the pelvic sidewall or lower third of the vagina.
-
stage IIa: involves upper 2/3rd of vagina without parametrial invasion
- stage IIa1: clinically visible tumour <4 cm in greatest dimension
- stage IIa2: clinically visible tumour >4 cm in greatest dimension
- stage IIb: with parametrial invasion
-
stage IIa: involves upper 2/3rd of vagina without parametrial invasion
-
stage III
- stage IIIa: tumour involves the lower third of the vagina with no extension to pelvic sidewall
- stage IIIb: extension to pelvic side wall or causing obstructive uropathy, MR imaging findings that are suggestive of pelvic sidewall involvement include tumour within 3 mm of or abutment of the internal obturator, levator ani, and pyriform muscles and the iliac vessel 6
-
stage IV: extension beyond true pelvis or biopsy proven to involve the mucosa of the bladder or the rectum
- stage IVa: extension beyond true pelvis or rectal/bladder invasion
- stage IVb: distant organ spread
For an imaging pathway on the best modalities in accurate staging of cervical cancer: see reference 9.
TMN Staging10
Primary Tumor (T)
- Tx: Primary tumor cannot be assessed
- T0: No evidence of primary tumor
- Tis: Carcinoma in situ
-
T1: Cervical carcinoma confined to the uterus
- T1a: Invasive carcinoma diagnosed only by microscopy
- T1b: Clinically visible lesion confined to the cervix
-
T2: Cervical carcinoma invades beyond uterus but not to pelvic wall or to lower third of vagina
- T2A: Tumor without parametrial invasion
- T2B: Tumor with parametrial invasion
-
T3: Tumor extends to pelvic wall and/or involves lower third of vagina, and/or causes hydronephrosis
- T3a: Tumor involves lower third of vagina, no extension to pelvic wall
- T3b: Tumor extends to pelvic wall and/or causes hydronephrosis
- T4: Tumor invades bladder or rectum, and/or extends beyond true pelvis
Regional Lymph nodes (N)
Nx: Regional lymph nodes cannot be assessed.
No: No regional lymph nodes metastatsis
N1: Regional lymph node metastases
Distant Metastasis (M)
M0: No distant mets
M1: Distant mets (including peritoneal spread, involvement of supraclavicular, mediastinal or para-aortic lymph nodes, lung, liver or bone).
See also
-<strong>stage 0:</strong> <a href="/articles/cervical-intraepithelial-neoplasia">cervical intraepithelial neoplasia</a> (HSIL or CIN III) </li>- +<strong>stage 0:</strong> <a href="/articles/cervical-intraepithelial-neoplasia-staging">cervical intraepithelial neoplasia</a> (HSIL or CIN III) </li>
-</ul><p>For an imaging pathway on the best modalities in accurate staging of cervical cancer: see <strong>reference 9</strong>.</p><h4>See also</h4><ul>-<li><a href="/articles/endometrial-carcinoma-staging-1">endometrial cancer staging</a></li>-<li><a href="/articles/staging-of-vaginal-cancer-1">vaginal cancer staging</a></li>-<li><a href="/articles/staging-of-vulval-cancer-1">vulval cancer staging</a></li>-<li><a href="/articles/ovarian-cancer-staging">ovarian cancer staging</a></li>- +</ul><p>For an imaging pathway on the best modalities in accurate staging of cervical cancer: see <strong>reference 9</strong>.</p><h5>TMN Staging<sup>10</sup>
- +</h5><h6>Primary Tumor (T)</h6><ul>
- +<li>Tx: Primary tumor cannot be assessed</li>
- +<li>T0: No evidence of primary tumor</li>
- +<li>Tis: Carcinoma in situ</li>
- +<li>T1: Cervical carcinoma confined to the uterus<ul>
- +<li>T1a: Invasive carcinoma diagnosed only by microscopy</li>
- +<li>T1b: Clinically visible lesion confined to the cervix</li>
- +</ul>
- +</li>
- +<li>T2: Cervical carcinoma invades beyond uterus but not to pelvic wall or to lower third of vagina<ul>
- +<li>T2A: Tumor without parametrial invasion</li>
- +<li>T2B: Tumor with parametrial invasion</li>
- +</ul>
- +</li>
- +<li>T3: Tumor extends to pelvic wall and/or involves lower third of vagina, and/or causes hydronephrosis<ul>
- +<li>T3a: Tumor involves lower third of vagina, no extension to pelvic wall</li>
- +<li>T3b: Tumor extends to pelvic wall and/or causes hydronephrosis</li>
- +</ul>
- +</li>
- +<li>T4: Tumor invades bladder or rectum, and/or extends beyond true pelvis</li>
- +</ul><h6>Regional Lymph nodes (N)</h6><p>Nx: Regional lymph nodes cannot be assessed.</p><p>No: No regional lymph nodes metastatsis</p><p>N1: Regional lymph node metastases</p><h6>Distant Metastasis (M)</h6><p>M0: No distant mets</p><p>M1: Distant mets (including peritoneal spread, involvement of supraclavicular, mediastinal or para-aortic lymph nodes, lung, liver or bone).</p><p> </p><h4>See also</h4><ul>
- +<li><a href="/articles/endometrial-carcinoma-staging-2">endometrial cancer staging</a></li>
- +<li><a href="/articles/vaginal-cancer-staging-1">vaginal cancer staging</a></li>
- +<li><a href="/articles/vulval-cancer-staging-1">vulval cancer staging</a></li>
- +<li><a href="/articles/ovarian-cancer-staging-1">ovarian cancer staging</a></li>
References changed:
- 10. American Joint Committee on Cancer - Cervix Uteri Cancer Staging <a href="https://cancerstaging.org/references-tools/quickreferences/Documents/CervixMedium.pdf</a><div class="ref_v2"></div>
- 10. American Joint Committee on Cancer - Cervix Uteri Cancer Staging <a href="https://cancerstaging.org/references-tools/quickreferences/Documents/CervixMedium.pdf</a><div class="ref_v2"></div>
- 10. American Joint Committee on Cancer https://cancerstaging.org/references-tools/quickreferences/Documents/CervixMedium.pdf
Unable to process the form. Check for errors and try again.