Carcinoma of the Uterine Cervix: FIGO Nomenclature (Montreal, 1994)


Stage 0: Carcinoma in situ, cervical intraepithelial neoplasia gradeI III.
Stage I: The carcinoma is strictly confined to the cervix (extension to the corpus would be disregarded).
 
Stage IA: Invasive carcinoma that can be diagnosed only by microscopy. All macroscopically visible lesions – even with superficial invasion – are allotted to stage IB carcinomas. Invasion is limited to a measured stromal invasion with a maximal depth of 5.0 mm and a horizontal extension no wider than 7.0 mm. (Depth of invasion should be no greater than 5.0 mm taken from the base of the epithelium of the original tissuesuperficial or glandular. The involvement of vascular spaces – venous or lymphatic – should not change the stage designation.)
  Stage IA1: Measured stromal invasion no greater than 3.0 mm in depth and extension no wider than 7.0 mm.
  Stage IA2: Measured stromal invasion greater than 3.0 mm and no greater than 5.0 mm with an extension no wider than 7.0 mm.

Stage IB: Clinically visible lesions limited to the cervix uteri or preclinical cancers greater than stage IA.
  Stage IB1: Clinically visible lesions no greater than 4.0 cm.
  Stage IB2: Clinically visible lesions greater than 4.0 cm.

Stage II: Cervical carcinoma invades beyond the uterus, but not to the pelvic wall or to the lower third of the vagina.
  Stage IIA: No obvious parametrial involvement.
  Stage IIB: Obvious parametrial involvement.

Stage III: The carcinoma has extended to the pelvic wall. On rectal examination, there is no cancer-free space between the tumor and the pelvic wall. The tumor involves the lower third of the vagina. All cases with hydronephrosis or nonfunctioning kidney are included, unless they are due to other causes.
  Stage IIIA: Tumor involves lower third of the vagina, with no extension to the pelvic wall.
  Stage IIIB: Extension to the pelvic wall and/or hydronephrosis or nonfunctioning kidney. (all node + are also IIIB)

Stage IV: The carcinoma has extended beyond the true pelvis, or has involved the mucosa of the bladder or rectum (biopsy-proven). (A bullous edema, as such, does not permit a case to be designated as stage IV.)
  Stage IVA: Spread to adjacent organs.
  Stage IVB: Spread to distant organs.

TNM Staging
  • TX: Primary tumor cannot be assessed
  • T0: No evidence of primary tumor
  • Tis: Carcinoma in situ
  • T1/I: Cervical carcinoma confined to uterus (extension to corpus should be disregarded)
    • T1a/IA: Invasive carcinoma diagnosed only by microscopy. All macroscopically visible lesions--even with superficial invasion--are T1b/IB. Stromal invasion with a maximal depth of 5 mm measured from the base of the epithelium and a horizontal spread of 7 mm or less. Vascular space involvement, venous or lymphatic, does not affect classification
    • T1a1/Ia1: Measured stromal invasion 3 mm or less in depth and 7 mm or less in horizontal spread
    • T1a2/IA2: Measured stromal invasion more than 3 mm and not more than 5 mm with a horizontal spread 7 mm or less
    • T1b/IB: Clinically visible lesion confined to the cervix or microscopic lesion greater than T1a2/IA2
    • T1b1/IB1: Clinically visible lesion 4 cm or less in greatest dimension
    • T1b2/IB2: Clinically visible lesion more than 4 cm in greatest dimension
  • T2/II: Cervical carcinoma invades beyond uterus but not to pelvic wall or to the lower third of the vagina
    • T2a/IIa: Tumor without parametrial involvement
    • T2b/IIb: Tumor with parametrial involvement
  • T3/III: Tumor extends to the pelvic wall and/or involves the lower third of the vagina, and/or causes hydronephrosis or nonfunctioning kidney
    • T3a/IIIA: Tumor involves lower third of the vagina, no extension to pelvic wall
    • T3b/IIIB: Tumor extends to pelvic wall and/or causes hydronephrosis or nonfunctioning kidney
  • T4/IVA: Tumor invades mucosa of the bladder or rectum, and/or extends beyond true pelvis (bullous edema is not sufficient to classify a tumor as T4)
    • M1/IVB: Distant metastasis

Regional lymph nodes (N)

  • NX: Regional lymph nodes cannot be assessed
  • N0: No regional lymph node metastasis
  • N1: Regional lymph node metastasis

AJCC stage groupings

Stage 0:  Tis, N0, M0

Stage 0 is carcinoma in situ, intraepithelial carcinoma. There is no stromal invasion.
Stage IA1:  T1a1, N0, M0
Stage IA2:  T1a2, N0, M0
Stage IB1:  T1b1, N0, M0
Stage IB2:  T1b2, N0, M0
Stage IIA:  T2a, N0, M0
Stage IIB:  T2b, N0, M0
Stage IIIA:  T3a, N0, M0
Stage IIIB:  T1, N1, M0 ,  T2, N1, M0,  T3a, N1, M0 ,  T3b, any N, M0
Stage IVA:  T4, any N, M0
Stage IVB:  Any T, any N, M1