Staging of cervical carcinoma

Author: Branko Perunovic, M.D. (see Authors page)

Revised: 26 April 2017, last major update May 2007

Copyright: (c) 2007-2017, PathologyOutlines.com, Inc.

PubMed search: FIGO cervical staging carcinoma

Cite this page: Staging of cervical carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cervixstaging.html. Accessed December 13th, 2017.
Definition / general
  • Many patients are treated with radiation therapy and never undergo surgical pathologic staging
  • Thus, AJCC prefers clinical staging (FIGO staging) of all patients for uniformity
  • Clinical stage should be determined prior to start of definitive therapy and not be altered because of subsequent findings once treatment has started
  • Pathologic findings should be recorded as pT, pN or pM but should not change the clinical staging
  • In AJCC 7th edition, TNM has changed to reflect FIGO 2008
Primary tumor and FIGO stage
  • TX: Primary tumor cannot be assessed
  • T0: No evidence of primary tumor
  • Tis: Carcinoma in situ (preinvasive carcinoma)
  • T1 (FIGO I): Cervical carcinoma confined to uterus (extension to corpus should be disregarded)
  • T1a (FIGO IA): Invasive carcinoma diagnosed only by microscopy (i.e. not macroscopically visible); stromal invasion has a maximum depth of 5.0 mm measured from the base of the epithelium and a horizontal spread of 7.0 mm or less; vascular space involvement (venous or lymphatic) does not affect classification
  • T1a1 (FIGO IA1): Measured stromal invasion 3.0 mm or less in depth and 7.0 mm or less in horizontal spread
  • T1a2 (FIGO IA2): Measured stromal invasion more than 3.0 mm and not more than 5.0 mm in depth with a horizontal spread 7.0 mm or less
  • T1b (FIGO IB): Clinically visible lesion confined to the cervix or microscopic lesion greater than T1a (FIGO IA2)
  • T1b1 (FIGO IB1): Clinically visible lesion 4.0 cm or less in greatest dimension
  • T1b2 (FIGO IB2): Clinically visible lesion more than 4.0 cm in greatest dimension
  • T2 (FIGO II): Cervical carcinoma invades beyond uterus but not to pelvic wall or to lower third of vagina
  • T2a (FIGO IIA): Tumor without parametrial invasion
  • T2a1 (FIGO IIA1): Clinically visible lesion 4.0 cm or less in greatest dimension
  • T2a 2(FIGO IIA2): Clinically visible lesion more than 4.0 cm in greatest dimension
  • T2b (FIGO IIB): Tumor with parametrial invasion
  • T3 (FIGO III): Tumor extends to pelvic wall or involves lower third of vagina or causes hydronephrosis or nonfunctioning kidney
  • T3a (FIGO IIIA): Tumor involves lower third of vagina, no extension to pelvic wall
  • T3b (FIGO IIIB): Tumor extends to pelvic wall or causes hydronephrosis or nonfunctioning kidney
  • T4 (FIGO IVA): Tumor invades mucosa of bladder or rectum or extends beyond true pelvis (bullous edema is not sufficient to classify a tumor as T4)
  • Note: all macroscopically visible lesions - even with only superficial invasion - are at least pT1b (FIGO IB)
Regional lymph nodes (N)
  • NX: Regional lymph nodes cannot be assessed
  • N0: No regional lymph node metastasis
  • N1 (FIGO IIIB): Regional lymph node metastasis
  • Note: Specify number of nodes examined and number positive
Distant Metastasis (M)
  • M0: No distant metastasis
  • M1 (FIGO IVB): Distant metastasis (including peritoneal spread, involvement of supraclavicular, mediastinal or paraaortic lymph nodes, lung, liver or bone)
Stage grouping
Stage 0 TA1s N0 M0
Stage I T1 N0 M0
Stage IA T1a N0 M0
Stage IA1 T1A1 N0 M0
Stage IA2 T1a2 N0 M0
Stage IB T1b N0 M0
Stage IB1 T1b1 N0 M0
IB2 T1b2 N0 M0
Stage II T2 N0 M0
Stage IIA T2a N0 M0
Stage IIA1 T2a1 N0 M0
IIA2 T2a2 N0 M0
Stage IIB T2b N0 M0
Stage III T3 N0 M0
Stage IIIA T3a N0 M0
Stage IIIB T1 - T3 N1 M0 or T3b any NM0
Stage IVA T4 any N M0
Stage IVB M1