Tumors of the cervix uteri can be staged using the TNM or FIGO classification systems.
|
Group |
Description |
TNM |
FIGO |
|
T |
primary tumor cannot be assessed |
TX |
|
|
|
no evidence of primary tumor |
T0 |
|
|
|
carcinoma in situ |
Tis |
|
|
|
tumor confined to the uterus |
T1 |
I |
|
|
tumor invades beyond the uterus but not to the pelvic wall or lower third of the vagina |
T2 |
II |
|
|
tumor extends to the pelvic wall and/or involves the lower third of vagina and/or causes hydronephrosis or nonfunctioning kidney |
T3 |
III |
|
|
tumor invades the mucosa of the bladder or rectum and/or extends beyond the true pelvis |
T4 |
IVA |
|
N |
regional lymph nodes cannot be assessed |
NX |
|
|
|
no regional lymph node metastasis |
N0 |
|
|
|
regional lymph node metastasis |
N1 |
|
|
M |
presence of distant metastasis cannot be assessed |
MX |
|
|
|
no definite metastasis |
M0 |
|
|
|
distant metastasis present |
M1 |
IVB |
where:
• The presence of bullous edema is not a criterion for T4.
• Regional lymph nodes: parametrial, paracervical, hypogastric, common iliac, external iliac, internal iliac, sacral, presacral.
• Distant metastasis most often are to para-aortic and mediastinal lymph nodes, lungs and bones.
|
Subgroup |
Description |
TNM |
FIGO |
|
T1 |
preclinical invasive carcinoma, diagnosed by microscopy only |
T1a |
IA |
|
|
minimal microscopic stromal invasion; stromal invasion <= 3.0 mm with horizontal spread <= 7.0 mm |
T1a1 |
IA1 |
|
|
stromal invasion > 3.0 mm but <= 5.0 mm; horizontal spread <= 7.0 mm |
T1a2 |
IA2 |
|
|
clinical visible lesion confined to the cervix or microscopic lesion greater than T1a2 |
T1b |
IB |
|
|
clinical visible lesion <= 4 cm in greatest dimension |
T1b1 |
IB1 |
|
|
clinical visible lesion > 4 cm in greatest dimension |
T1b2 |
IB2 |
where:
• A macroscopically visible lesion is at least T1b even if only superficial invasion.
• Stromal invasion is measured from the base of the normal surface epithelium.
• Vascular involvement does not affect the classification.
|
Subgroup |
Description |
TNM |
FIGO |
|
T2 |
tumor without parametrial invasion |
T2a |
IIA |
|
|
tumor with parametrial invasion |
T2b |
IIB |
|
Subgroup |
Description |
TNM |
FIGO |
|
T3 |
tumor involves the lower third of the vagina but does not extend to the pelvic wall |
T3a |
IIIA |
|
|
tumor extends to the pelvic wall and/or causes hydronephrosis or a nonfunctioning kidney |
T3b |
IIIB |
|
TNM |
Stage |
|
Tis N0 M0 |
0 |
|
T1a1 N0 M0 |
IA1 |
|
T1a2 N0 M0 |
IA2 |
|
T1b1 N0 M0 |
IB1 |
|
T1b2 N0 M0 |
IB2 |
|
T2a N0 M0 |
IIA |
|
T2b N0 M0 |
IIB |
|
T3a N0 M0 |
IIIA |
|
T1 N1 M0 T2 N1 M0 T3a N1 M0 T3b N0-1 M0 |
IIIB |
|
T4 N0-1 M0 |
IVA |
InfoSpecialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology |
