02/02/22 20.

18 Cervical Cancer Staging: TNM and FIGO Classifications for Cervical Cancer

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Cervical Cancer Staging 

Updated: Apr 26, 2019
Author: Cecelia H Boardman, MD; Chief Editor: Yukio Sonoda, MD  more...

TNM and FIGO Classifications for Cervical Cancer

The American Joint Committee on Cancer (AJCC) TNM classification and the International
Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer are provided
below.
[1, 2, 3]

Table 1. TNM and FIGO Classifications for Cervical Cancer (Open Table in a new window)

Primary tumor (T)

TNM FIGO Surgical-Pathologic Findings

Categories Stages  

TX   Primary tumor cannot be assessed

T0   No evidence of primary tumor

Tis   Carcinoma in situ (preinvasive carcinoma)

Cervical carcinoma confined to the cervix (disregard extension to the

T1 I
corpus)

T1a IA Invasive carcinoma diagnosed only by microscopy; stromal invasion

with a maximum depth of < 5.0 mm, measured from the base of the
epithelium; vascular space involvement, venous or lymphatic, does
not affect classification

 
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T1a1 IA1 Measured stromal invasion < 3.0 mm in depth 

T1a2 IA2 Measured stromal invasion ≥ 3.0 mm and < 5.0 mm 

Invasive carcinoma with measured deepest invasion ≥ 5 mm (greater

T1b IB
than stage IA), lesion limited to the cervix 

Invasive carcinoma with ≥ 5 mm depth of stromal invasion and < 2 cm

T1b1 IB1
in greatest dimension

T1b2 IB2 Invasive carcinoma, 2 cm to < 4 cm in greatest dimension

T1b3 IB3 Invasive carcinoma, ≥ 4 cm in greatest dimension

Cervical carcinoma invades beyond uterus but not to pelvic wall or to

T2 II
lower third of vagina

Involvement limited to the upper two-thirds of the vagina, without

T2a IIA
parametrial invasion

T2a1 IIA1 Invasive carcinoma < 4 cm in greatest dimension

T2a2 IIA2 Invasive carcinoma ≥ 4 cm in greatest dimension

T2b IIB Tumor with parametrial invasion but not up to the pelvic wall

Carcinoma involves the lower third of the vagina and/or extends to the
T3 III pelvic wall and/or causes hydronephrosis or nonfunctioning kidney
and/or involves pelvic and/or para-aortic lymph nodes

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T3a IIIA Tumor involves lower third of vagina, with no extension to pelvic wall

Tumor extends to pelvic wall and/or causes hydronephrosis or

T3b IIIB
nonfunctional kidney

Involvement of pelvic and/or para-aortic lymph nodes, irrespective of

T3c IIIC
tumor size and extent (with r [imaging] and p [pathology] notations)

T3c1 IIIC1 Pelvic lymph node metastasis only

T3c2 IIIC2 Para-aortic lymph node metastasis

The carcinoma has extended beyond the true pelvis or has involved
T4 IV (biopsy proven) the mucosa of the bladder or rectum. (A bullous
edema, as such, does not permit a case to be allotted to stage IV.)

  IVA Spread to adjacent pelvic organs

  IVB Spread to distant organs

Regional lymph nodes (N)

NX Regional lymph nodes cannot be assessed

N0 No regional lymph node metastasis

N0 (i+) Isolated tumor cells in regional lymph node(s) ≤ 0.2 mm

N1 Regional lymph node metastasis

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Distant metastasis (M)

M0 No distant metastasis

Distant metastasis (including peritoneal spread; involvement of supraclavicular,

M1
mediastinal, or distant lymph nodes; and lung, liver, or bone) 

Table 2. AJCC Prognostic Groups (Open Table in a new window)

Stage Tumor Node Metastasis

I T1 Any N M0

IAI T1a Any N M0

IA2 T1a1 Any N M0

IB T1b Any N M0

IB1 T1b1 Any N M0

IB2 T1b2 Any N M0

II T2 Any N M0

IIA T2a Any N M0

IIA1 T2a1 Any N M0

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IIA2 T2a2 Any N M0

IIB T2b Any N M0

III T3 Any N M0

IIIA T3a Any N M0

IIIB T3b Any N M0

IVA T4 Any N M0

IVB Any T Any N M1

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