Cervical cancer staging is primarily based on the FIGO (International Federation of Gynecology and Obstetrics) system, which helps determine the extent of the disease and guide treatment decisions. It is important to understand that staging involves clinical examination, imaging, and sometimes surgical evaluation.
FIGO Staging for Cervical Cancer:
Stage I: Tumor is confined to the cervix.
Stage IA: Microscopic disease (cancer is only visible under a microscope)
IA1: Invasion is ≤ 3 mm in depth and ≤ 7 mm wide.
IA2: Invasion is > 3 mm and ≤ 5 mm in depth and ≤ 7 mm wide.
Stage IB: Clinically visible lesions or microscopic lesions > IA2
IB1: Visible lesion ≤ 2 cm.
IB2: Visible lesion > 2 cm but ≤ 4 cm.
IB3: Visible lesion > 4 cm.
Stage II:
Tumor has spread beyond the cervix but not to the pelvic wall or the lower third of the vagina.
Tumor has spread beyond the cervix but not to the pelvic wall or the lower third of the vagina.
Stage IIA: No parametrial invasion.
IIA1: Lesion ≤ 4 cm.
IIA2: Lesion > 4 cm.
Stage IIB: Parametrial invasion present, but not extending to the pelvic sidewall.
Stage III:
Tumor has spread to the pelvic wall, lower third of the vagina, or has caused kidney problems (hydronephrosis).
Stage IIIA: Tumor involves the lower third of the vagina, but not the pelvic wall.
Stage IIIB: Tumor extends to the pelvic wall and/or causes hydronephrosis or non-functioning kidney.
Stage IIIC: Involvement of pelvic and/or para-aortic lymph nodes.
Stage IIIC: Involvement of pelvic and/or para-aortic lymph nodes.
IIIC1: Pelvic lymph node metastasis only.
IIIC2: Para-aortic lymph node metastasis.
Stage IV:
Tumor has spread to nearby organs or distant parts of the body.
Tumor has spread to nearby organs or distant parts of the body.
Stage IVA: Spread to the bladder or rectum.
Stage IVB: Spread to distant organs (like lungs, liver, or bones).
Key Points:
Clinical Examination: Pelvic examination, cystoscopy, proctoscopy, and colposcopy may be used for clinical staging.
Clinical Examination: Pelvic examination, cystoscopy, proctoscopy, and colposcopy may be used for clinical staging.
Imaging: MRI, CT, or PET scans help assess tumor size, parametrial invasion, and lymph node involvement.