Cervical cancer

The staging of cervical tumours is by the Fe´deration Internationale de Gyne´cologie et d’Obste´trique (FIGO) and TNM classification (Union for International Cancer Control), (2).

TNM clinical classification

TNM categories

FIGO stages

Definition

T – Primary Tumour

TX

Primary tumour cannot be assessed

T0

No evidence of primary tumour

Tis

Carcinoma in situ (preinvasive carcinoma)

T1

I

Tumour confined to the cervix

T1a

IA

Invasive carcinoma diagnosed only by microscopy. Stromal invasion with a maximal depth of

5.0 mm measured from the base of the epithelium and a horizontal spread of 7.0 mm or less

T1a1

IA1

Measured stromal invasion 3.0 mm or less in depth and 7.0 mm or less in horizontal spread

T1a2

IA2

Measured stromal invasion more than 3.0 mm and not more than 5.0 mm with a horizontal

spread of 7.0 mm or less

T1b

IB

Clinically visible lesion confined to the cervix or microscopic lesion greater than T1a/IA2

T1b1

IB1

Clinically visible lesion 4.0 cm or less in greatest dimension

T1b2

IB2

Clinically visible lesion more than 4.0 cm in greatest dimension

T2

II

Tumour invades beyond uterus but not to pelvic wall or to lower third of vagina

T2a

IIA

Tumour without parametrial invasion

T2a1

IIA1

Clinically visible lesion 4.0 cm or less in greatest dimension

T2a2

IIA2

Clinically visible lesion more than 4.0 cm in greatest dimension

T2b

IIB

Tumour with parametrial invasion

T3

III

Tumour involves lower third of vagina, or extends to pelvic wall, or causes hydronephrosis or

non-functioning kidney

T3a

IIIA

Tumour involves lower third of vagina

T3b

IIIB

Tumour extends to pelvic wall, or causes hydronephrosis or non-functioning kidney

T4

IVA

Tumour invades mucosa of the bladder or rectum, or extends beyond true pelvis^e

N – Regional Lymph Nodes

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

Regional lymph node metastasis

M – Distant Metastasis

M0

No distant metastasis

M1

Distant metastasis (includes inguinal lymph nodes and intraperitoneal disease). It excludes

      metastasis to vagina, pelvic serosa, and adnexa

   James D, Brierley JD, Gospodarowicz MK et al. (eds). TNM Classification of Malignant Tumours, 8th edition. Oxford, UK: John Wiley & Sons, Inc. 2016.