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International Federation of Gynecology and Obstetrics (FIGO) staging of cancer of the cervix uteri (2018; corrigendum 2019)

International Federation of Gynecology and Obstetrics (FIGO) staging of cancer of the cervix uteri (2018; corrigendum 2019)
Stage Description
I The carcinoma is strictly confined to the cervix (extension to the uterine corpus should be disregarded)
IA Invasive carcinoma that can be diagnosed only by microscopy, with maximum depth of invasion <5 mm*
IA1 Measured stromal invasion ≤3 mm in depth
IA2 Measured stromal invasion >3 mm and ≤5 mm in depth
IB Invasive carcinoma with measured deepest invasion >5 mm (greater than Stage IA), lesion limited to the cervix uteri
IB1 Invasive carcinoma >5 mm depth of stromal invasion, and ≤2 cm in greatest dimension
IB2 Invasive carcinoma >2 cm and ≤4 cm in greatest dimension
IB3 Invasive carcinoma >4 cm in greatest dimension
II The carcinoma invades beyond the uterus, but has not extended onto the lower third of the vagina or to the pelvic wall
IIA Involvement limited to the upper two-thirds of the vagina without parametrial involvement
IIA1 Invasive carcinoma ≤4 cm in greatest dimension
IIA2 Invasive carcinoma >4 cm in greatest dimension
IIB With parametrial involvement but not up to the pelvic wall
III The carcinoma involves the lower third of the vagina and/or extends to the pelvic wall and/or causes hydronephrosis or nonfunctioning kidney and/or involves pelvic and/or paraaortic lymph nodesΔ
IIIA The carcinoma involves the lower third of the vagina, with no extension to the pelvic wall
IIIB Extension to the pelvic wall and/or hydronephrosis or nonfunctioning kidney (unless known to be due to another cause)
IIIC Involvement of pelvic and/or paraaortic lymph nodes (including micrometastases), irrespective of tumor size and extent (with r and p notations)Δ
IIIC1 Pelvic lymph node metastasis only
IIIC2 Paraaortic lymph node metastasis
IV The carcinoma has extended beyond the true pelvis or has involved (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
When in doubt, the lower staging should be assigned.

* Imaging and pathology can be used, where available, to supplement clinical findings with respect to tumor size and extent, in all stages.

¶ The involvement of vascular/lymphatic spaces does not change the staging. The lateral extent of the lesion is no longer considered.

Δ Adding notation of r (imaging) and p (pathology) to indicate the findings that are used to allocate the case to Stage IIIC. Example: If imaging indicates pelvic lymph node metastasis, the stage allocation would be Stage IIIC1r, and if confirmed by pathologic findings, it would be Stage IIIC1p. The type of imaging modality or pathology technique used should always be documented.

From: Bhatla N, Aoki D, Sharma DN, Sankaranarayanan R. Cancer of the cervix uteri. Int J Gynaecol Obstet 2018; 143 S2:22. Available at: https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12611. Reproduced under the terms of the Creative Commons License 4.0.

Updated with information from: Corrigendum to "Revised FIGO Staging for Carcinoma of the Cervix Uteri." Int J Gynaecol Obstet 2019; 147:279.
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