Cervical cancer staging
Dr Yuranga Weerakkody and Dr Frank Gaillard et al.
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 (CIN III)
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stage I : confined to cervix
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stage Ia : invasive carcinoma only diagnosed by microscopy.
- Ia1 : stromal invasion < 3 mm in depth and < 7 mm in extension
- Ia2 : stromal invasion > 3 mm depth and not > 5 mm and extension < 7 mm
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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
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stage Ia : invasive carcinoma only diagnosed by microscopy.
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stage II : beyond cervix though not to the pelvic sidewall or lower third of the vagina.
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stage IIa 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
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stage IIa without parametrial invasion
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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
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stage IV : extension beyond pelvis or biopsy proven to involve the mucosa of the bladder or the rectum
- stage IVa : extension beyond pelvis or rectal / bladder invasion
- stage IVb : distant organ spread
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