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Cite this page: Staging. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/vulvastaging.html. Accessed July 16th, 2017.
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 ( )
Regional lymph nodes (N) and FIGO stages in ( )
Distant Metastasis (M) and FIGO stages in ( )
Stage grouping
- 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
Additional references
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