Cervical cancer staging

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 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 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

See also

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