Topic Completed: 1 August 2016

Minor changes: 19 March 2019

Copyright: 2002-2019,, Inc.

PubMed Search: Staging vulvar carcinoma

Sarah Strickland, M.D.
Page views in 2019: 576
Page views in 2020 to date: 316
Cite this page: Strickland S. Staging. website. Accessed May 24th, 2020.
Definition / general
  • Based on AJCC 7th edition / UICC
  • Includes tumors with primary site of growth in vulva only; excludes mucosal melanoma
  • Depth of invasion is defined as the measurement of the tumor from the epithelial-stromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion
  • FIGO no longer uses Tis
  • FIGO uses classification T2 / T3, defined as T2 in TNM
  • FIGO uses classification T4, defined as T3 in TNM
Essential features
Primary tumor (T) and FIGO stage in ( )
  • TX: Primary tumor cannot be assessed
  • T0: No evidence of primary tumor
  • Tis: High-grade squamous intraepithelial lesion (carcinoma in situ, VIN 2 - 3, preinvasive carcinoma)
  • T1a (IA): Lesions 2 cm or less in size, confined to the vulva or perineum, and with stromal invasion 1.0 mm or less
  • T1b (IB): Lesions more than 2 cm in size OR any size with stromal invasion more than 1.0 mm, confined to the vulva or perineum
  • T2 (II): Tumor of any size with extension to adjacent perineal structures (lower/distal 1/3 urethra, lower/distal 1/3 vagina, anal involvement)
  • T3 (IVA): Tumor of any size with extension to any of the following: upper/proximal 2/3 of urethra, upper/proximal 2/3 of vagina, bladder mucosa, rectal mucosa, or fixed to pelvic bone

Regional lymph nodes (N) and FIGO stages in ( )
  • NX: Regional lymph nodes cannot be assessed
  • N0: No regional lymph node metastasis
  • N1: One or two regional lymph nodes with the following features:
  • N1a (IIIA): 1 or 2 lymph node metastasis 5 mm or less
  • N1b (IIIA): 1 lymph node metastasis 5 mm or greater
  • N2 (IIIB): Regional lymph node metastasis with the following features:
  • N2a (IIIB): Three or more lymph node metastases each less than 5 mm
  • N2b (IIIB): Two or more lymph node metastases 5 mm or greater
  • N2c (IIIC): Lymph node metastasis with extracapsular spread
  • N3 (IVA): Fixed or ulcerated regional lymph node metastasis

  • Note: The site and laterality of lymph node metastases should be described

Distant Metastasis (M) and FIGO stages in ( )
  • M0: No distant metastasis
  • M1 (IVB): Distant metastasis (including pelvic lymph node metastasis)

Stage grouping
  • Stage 0: Tis N0 M0
  • Stage I: T1 N0 M0
  • Stage IA: T1a N0 M0
  • Stage IB: T1b N0 M0
  • Stage II: T2 N0 M0
  • Stage IIIA: T1-T2 N1a-b M0
  • Stage IIIB: T1-T2 N2a-b M0
  • Stage IIIC: T1-T2 N2c M0
  • Stage IVA: T1-T2 N3 M0 or T3 any N M0
  • Stage IVB: M1
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