Cervical cancer (staging)

Staging of cervical cancer can either be based on the TNM or FIGO system.

Revised FIGO staging of cervical carcinoma 2018 8
  • FIGO no longer includes Stage 0 (Tis)
  • I: confined to cervix uteri (extension to the corpus should be disregarded)
    • IA: invasive carcinoma only diagnosed by microscopy
      • IA1: stromal invasion <3 mm in depth
      • IA2: stromal invasion ≥3 mm and <5 mm in depth
    • IB: invasive carcinoma with measured deepest invasion ≥5 mm (greater than stage IA), lesion limited to the cervix uteri
      • IB1: invasive carcinoma ≥5 mm depth of stromal invasion and <2 cm in greatest dimension
      • IB2: invasive carcinoma ≥2 cm and <4 cm in greatest dimension
      • IB3: invasive carcinoma ≥4 cm in greatest dimension
  • II: beyond the uterus, but has not extended onto the lower third of the vagina or to the pelvic wall
    • IIA: involvement limited to the upper 2/3rd of vagina without parametrial invasion
      • IIA1: invasive carcinoma <4 cm in greatest dimension
      • IIA2: invasive carcinoma >4 cm in greatest dimension
    • IIB: with parametrial involvement but not up to the pelvic wall
  • III: carcinoma involves the lower third of the vagina and/or extends to the pelvic wall and/or causes hydronephrosis or non‐functioning kidney and/or involves pelvic and/or paraaortic lymph nodes
    • IIIA: carcinoma involves the lower third of the vagina, with no extension to the pelvic wall
    • IIIB: extension to the pelvic wall and/or hydronephrosis or non‐functioning kidney (unless known to be due to another cause)
    • IIIC: involvement of pelvic and/or paraaortic lymph nodes, irrespective of tumor size and extent
      • IIIC1: pelvic lymph node metastasis only
      • IIIC2: paraaortic lymph node metastasis
      • with r (imaging) and p (pathology) notations to indicate how lymph nodes were identified
  • IV: carcinoma has extended beyond the true pelvis or has involved (biopsy proven) the mucosa of the bladder or rectum (bullous edema, as such, does not permit a case to be allotted to stage IV)
    • IVA: spread to adjacent organs
    • IVB: spread to distant organs

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

Article information

rID: 1091
Section: Staging
Synonyms or Alternate Spellings:
  • Cervical carcinoma staging
  • Staging of cervical carcinoma
  • Staging of cervical cancer
  • Staging of carcinoma of the cervix
  • Staging of carcinoma of cervix

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Cases and figures

  • Case 1: stage IV
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  • Case 2: stage IVa
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