Staging of Carcinoma of the Cervix Uteri FIGO Nomenclature

Stage 0 Carcinoma in situ, cervical intraepithelial neoplasia Grade III

Stage I The carcinoma is strictly confined to the cervix (extension to the corpus would be disregarded).

la 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 of not more than 7.0 mm. Depth of invasion should not be more than 5.0 mm taken from the base of the epithelium of the original tissue-superficial or glandular. The involvement of vascular spaces-venous or lymphatic-should not change the stage allotment.

la1 Measured stromal invasion of not more than 3.0 mm in depth and extension of not more than 7.0 mm Ia2 Measured stromal invasion of more than 3.0 mm and not more than 5.0 mm with an extension of not more than 7.0 mm Ib Clinically visible lesions limited to the cervix uteri or preclinical cancers greater than Stage la Ib1 Clinically visible lesions not more than 4.0 cm

Ib2 Clinically visible lesions more 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

Ila No obvious parametrial involvement 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 known to be due to other causes.

IIIa Tumor involves lower third of the vagina, with no extension to the pelvic wall IIIb Extension to the pelvic wall or hydronephrosis or nonfunctioning kidney

Stage IV The carcinoma has extended beyond the true pelvis, or has involved (biopsy proved) the mucosa of the bladder or rectum. Bullous edema, as such, does not permit a case to be allotted to Stage IV.

IVa Spread of the growth to adjacent organs (bladder or rectum or both) IVb Spread to distant organs

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