FIGO STAGING SYSTEM

The FIGO staging system are determined by the International Federation of

Gynecology and Obstetrics (Fdration Internationale de Gyncologie et dObsttrique).
In general, there are 5 stages:

stage 0: carcinoma in situ (common in cervical, vaginal, and vulval cancer)

stage I: confined to the organ of origin

stage II: invasion of surrounding organs or tissue

stage III: spread to distant nodes or tissue within the pelvis

stage IV: distant metastasis(es)

General Concept and Purposes

The purpose of the staging system is to provide uniform terminology for better
communication among health professionals and to provide appropriate prognosis to the
patients which results in treatment improvement.
This is a constantly evolving process as new therapeutic modalities are developed, new
imaging and surgical approaches are applied, and more prognostic information becomes
available.
The previous system did not reflect the prognosis in some patient subsets where medical
research and practice have shown explosive growth of new knowledge in recent year

CARCINOMA OF THE VULVA

IA
Tumor confined to the vulva or perineum, 2cm in size with stromal invasion
1mm, negative nodes
IB
Tumor confined to the vulva or perineum, > 2cm in size or with stromal invasion
> 1mm, negative nodes
II
Tumor of any size with adjacent spread (1/3 lower urethra, 1/3 lower vagina,
anus), negative nodes
IIIA

Tumor of any size with positive inguino-femoral lymph nodes

(i) 1 lymph node metastasis greater than or equal to 5 mm
(ii) 1-2 lymph node metastasis(es) of less than 5 mm

IIIB

(i) 2 or more lymph nodes metastases greater than or equal to 5 mm

(ii) 3 or more lymph nodes metastases less than 5 mm

IIIC

Positive node(s) with extracapsular spread

IVA
(i) Tumor invades other regional structures (2/3 upper urethra, 2/3 upper vagina),
bladder mucosa, rectal mucosa, or fixed to pelvic bone
(ii) Fixed or ulcerated inguino-femoral lymph nodes

IVB

Any distant metastasis including pelvic lymph nodes

CARCINOMA OF THE CERVIX

IA1
Confined to the cervix, diagnosed only by microscopy with invasion of < 3 mm in
depth and lateral spread < 7 mm
IA2
Confined to the cervix, diagnosed with microscopy with invasion of > 3 mm and
< 5 mm with lateral spread < 7mm
IB1

Clinically visible lesion or greater than A2, < 4 cm in greatest dimension

IB2

Clinically visible lesion, > 4 cm in greatest dimension

IIA1
Involvement of the upper two-thirds of the vagina, without parametrial invasion,
< 4 cm in greatest dimension
IIA2

> 4 cm in greatest dimension

IIB

With parametrial involvement

IIIA/B Unchanged
IVA/B

Unchanged

CARCINOMA OF THE ENDOMETRIUM

IA
Tumor confined to the uterus, no or < myometrial invasion
IB

Tumor confined to the uterus, > myometrial invasion

II

Cervical stromal invasion, but not beyond uterus

IIIA

Tumor invades serosa or adnexa

IIIB

Vaginal and/or parametrial involvement

IIIC1

Pelvic node involvement

IIIC2

Para-aortic involvement

IVA

Tumor invasion bladder and/or bowel mucosa

IVB

Distant metastases including abdominal metastases and/or inguinal lymph nodes

UTERINE SARCOMAS (LEIOMYOSARCOMA, ENDOMETRIAL STROMAL SARCOMA,

AND ADENOSARCOMA)
IA
Tumor limited to uterus < 5 cm

IB

Tumor limited to uterus > 5 cm

IIA

Tumor extends to the pelvis, adnexal involvement

IIB

Tumor extends to extra-uterine pelvic tissue

IIIA

Tumor invades abdominal tissues, one site

IIIB

More than one site

IIIC

Metastasis to pelvic and/or para-aortic lymph nodes

IVA

Tumor invades bladder and/or rectum

IVB

Distant metastasis

ADENOSARCOMA STAGE I DIFFERS FROM OTHER UTERINE SARCOMAS

IA
Tumor limited to endometrium/endocervix
IB

Invasion to < myometrium

IB

Invasion to > myometrium