Vulval cancer (staging)
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- updated 19 Dec 2022:
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Staging of vulval cancer can be done with either the AJCC or FIGO systems, although both are similar.
Staging
FIGO
-
stage I:
tumortumour confined to the vulva- IA lesions ≤2 cm in size, confined to the vulva or perineum and with stromal invasion ≤1.0 mm*, no nodal metastasis
- IB: lesions N2 cm in size or with stromal invasion N1.0 mm*, confined to the vulva or perineum, with negative nodes
-
stage II:
tumortumour of any size with extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with negative nodes -
stage III
:tumor:tumour of any size with or without extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with positive inguinal-femoral lymph nodes- IIIA: with 1 lymph node metastasis (≥5 mm), or 1–2 lymph node metastasis(es)
- IIIB:with 2 or more lymph node metastases (≥5 mm), or 3 or more lymph node metastases
- IIIC: with positive nodes with extracapsular spread
-
stage IV:
tumortumour invades other regional (2/3 upper urethra, 2/3 upper vagina), or distant structures-
IVA
:tumor:tumour invades any of the following:- (i) upper urethral and/or vaginal mucosa, bladder mucosa, rectal mucosa, or fixed to pelvic bone, or
- (ii) fixed or ulcerated inguino-femoral lymph nodes
- IVB: any distant metastasis including pelvic lymph nodes
-
IVA
Practical points
- vulval melanoma cannot be staged using these systems 2
See also
-<p><strong>Staging of vulval cancer</strong> can be done with either the AJCC or FIGO systems, although both are similar. </p><h4>Staging</h4><h5>FIGO</h5><ul>-<li>-<strong>stage I:</strong>tumor confined to the vulva<ul>-<li>-<strong>IA </strong>lesions ≤2 cm in size, confined to the vulva or perineum and with stromal invasion ≤1.0 mm*, no nodal metastasis</li>-<li>-<strong>IB: </strong>lesions N2 cm in size or with stromal invasion N1.0 mm*, confined to the vulva or perineum, with negative nodes</li>-</ul>-</li>-<li>-<strong>stage II:</strong> tumor of any size with extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with negative nodes</li>-<li>-<strong>stage III</strong> :tumor of any size with or without extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with positive inguinal-femoral lymph nodes<ul>-<li>-<strong>IIIA</strong>: with 1 lymph node metastasis (≥5 mm), <em>or</em> 1–2 lymph node metastasis(es)</li>-<li>-<strong>IIIB</strong>:<strong> </strong>with 2 or more lymph node metastases (≥5 mm), <em>or </em>3 or more lymph node metastases</li>-<li>-<strong>IIIC</strong>: with positive nodes with extracapsular spread</li>-</ul>-</li>-<li>-<strong>stage IV: </strong>tumor invades other regional (2/3 upper urethra, 2/3 upper vagina), or distant structures<ul>-<li>-<strong>IVA</strong> :tumor invades any of the following:<ul>-<li>-<strong>(i)</strong> upper urethral and/or vaginal mucosa, bladder mucosa, rectal mucosa, or fixed to pelvic bone, <em>or</em>-</li>-<li>-<strong>(ii) </strong>fixed or ulcerated inguino-femoral lymph nodes</li>-</ul>-</li>-<li>-<strong>IVB</strong>: any distant metastasis including pelvic lymph nodes</li>-</ul>-</li>-</ul><h4>Practical points</h4><ul><li>vulval melanoma cannot be staged using these systems <sup>2</sup>-</li></ul><h4>See also</h4><ul>-<li><a href="/articles/primary-vulval-cancer">primary vulval cancer</a></li>-<li><a href="/articles/figo-staging-system">FIGO staging system</a></li>- +<p><strong>Staging of vulval cancer</strong> can be done with either the AJCC or FIGO systems, although both are similar. </p><h4>Staging</h4><h5>FIGO</h5><ul>
- +<li>
- +<strong>stage I:</strong>tumour confined to the vulva<ul>
- +<li>
- +<strong>IA </strong>lesions ≤2 cm in size, confined to the vulva or perineum and with stromal invasion ≤1.0 mm*, no nodal metastasis</li>
- +<li>
- +<strong>IB: </strong>lesions N2 cm in size or with stromal invasion N1.0 mm*, confined to the vulva or perineum, with negative nodes</li>
- +</ul>
- +</li>
- +<li>
- +<strong>stage II:</strong> tumour of any size with extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with negative nodes</li>
- +<li>
- +<strong>stage III</strong> :tumour of any size with or without extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with positive inguinal-femoral lymph nodes<ul>
- +<li>
- +<strong>IIIA</strong>: with 1 lymph node metastasis (≥5 mm), <em>or</em> 1–2 lymph node metastasis(es)</li>
- +<li>
- +<strong>IIIB</strong>:<strong> </strong>with 2 or more lymph node metastases (≥5 mm), <em>or </em>3 or more lymph node metastases</li>
- +<li>
- +<strong>IIIC</strong>: with positive nodes with extracapsular spread</li>
- +</ul>
- +</li>
- +<li>
- +<strong>stage IV: </strong>tumour invades other regional (2/3 upper urethra, 2/3 upper vagina), or distant structures<ul>
- +<li>
- +<strong>IVA</strong> :tumour invades any of the following:<ul>
- +<li>
- +<strong>(i)</strong> upper urethral and/or vaginal mucosa, bladder mucosa, rectal mucosa, or fixed to pelvic bone, <em>or</em>
- +</li>
- +<li>
- +<strong>(ii) </strong>fixed or ulcerated inguino-femoral lymph nodes</li>
- +</ul>
- +</li>
- +<li>
- +<strong>IVB</strong>: any distant metastasis including pelvic lymph nodes</li>
- +</ul>
- +</li>
- +</ul><h4>Practical points</h4><ul><li>vulval melanoma cannot be staged using these systems <sup>2</sup>
- +</li></ul><h4>See also</h4><ul>
- +<li><a href="/articles/primary-vulval-cancer">primary vulval cancer</a></li>
- +<li><a href="/articles/figo-staging-system">FIGO staging system</a></li>
Images Changes:
Image 1 X-ray (Frontal) ( create )
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Case 1: stage IVB
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