Cervical cancer staging
Cervical cancer is staged by the International Federation of Gynecology and Obstetrics (FIGO) staging system, which is based on clinical examination, rather than surgical findings. It allows only the following diagnostic tests to be used in determining the stage: palpation, inspection, colposcopy, endocervical curettage, hysteroscopy, cystoscopy, proctoscopy, intravenous urography, andX-ray examination of the lungs and skeleton, and cervical conization.
- Stage I The carcinoma is strictly confined to the cervix (extension to the corpus would
be disregarded)
- IA Invasive carcinoma which can be diagnosed only by microscopy, with deepest
invasion <5 mm and the largest extension >7 mm
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- IA1 Measured stromal invasion of <3.0 mm in depth and extension of <7.0 mm
-
- IA2 Measured stromal invasion of >3.0 mm and not >5.0 mm with an extension of
not >7.0 mm
- IB Clinically visible lesions limited to the cervix uteri or pre-clinical cancers
greater than stage IA
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- IB1 Clinically visible lesion <4.0 cm in greatest dimension
-
- IB2 Clinically visible lesion >4.0 cm in greatest dimension
- Stage II Cervical carcinoma invades beyond the uterus, but not to the pelvic wall or to the lower third of the vagina
- IIA Without parametrial invasion
- IIA1 Clinically visible lesion <4.0 cm in greatest dimension
-
- IIA2 Clinically visible lesion >4.0 cm in greatest dimension
- IIB With obvious parametrial invasion
- Stage III The tumour extends to the pelvic wall and/or involves lower third of the vagina and/or causes hydronephrosis or non-functioning kidney
- IIIA Tumour involves 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
- Stage IV The carcinoma has extended beyond the true pelvis or has involved (biopsy proven) the mucosa of the bladder or rectum. A bullous oedema, as such, does not permit a case to be allotted to Stage IV
- IVA Spread of the growth to adjacent organs
- IVB Spread to distant organs
Treatment is discussed below, but should be individualised to the patient, her age, reproductive goals, functional status, and access to health care resources.