Cervical cancer staging

Stage 1A cervical cancer
Stage 1B cervical cancer
Stage 2A cervical cancer
Stage 2B cervical cancer
Stage 3B cervical cancer
Stage 4A cervical cancer
Stage 4B cervical cancer

Cervical cancer staging is the assessment of cervical cancer to decide how far the disease has progressed. Cancer staging generally runs from stage 0, which is pre-cancerous or non-invasive, to stage 4, in which the cancer has spread throughout a significant part of the body. As a general rule, Stage 0 is easily cured and Stage 4 is incurable.

Cervical cancer is staged by the International Federation of Gynecology and Obstetrics (FIGO) staging system, which is based on clinical examination, rather than surgical findings. It allows only the following diagnostic tests to be used in determining the stage: palpation (feeling with the fingers), inspection, colposcopy, endocervical curettage, hysteroscopy, cystoscopy, proctoscopy, intravenous urography, and X-ray examination of the lungs and skeleton, and cervical conization.

Stages

Stage 0
The carcinoma is confined to the surface layer (cells lining) of the cervix. Also called carcinoma in situ (CIS).
Stage I
The carcinoma has grown deeper into the cervix, but has not spread beyond it (extension to the corpus would be disregarded). Stage One is subdivided as follows:
IA Invasive carcinoma which can be diagnosed only by microscopy, with deepest invasion <5 mm and the largest extension <7 mm
IA-1 Measured stromal invasion of <3.0 mm in depth and extension of <7.0 mm
IA-2 Measured stromal invasion of >3.0 mm and not >5.0 mm with an extension of not >7.0 mm
IB Clinically visible lesions limited to the cervix uteri or pre-clinical cancers greater than stage IA
IB-1 Clinically visible lesion <4.0 cm in greatest dimension
IB-2 Clinically visible lesion >4.0 cm in greatest dimension
Stage II
Cervical carcinoma invades beyond the uterus, but not to the pelvic wall or to the lower third of the vagina
IIA Without parametrial invasion
IIA-1 Clinically visible lesion <4.0 cm in greatest dimension
IIA-2 Clinically visible lesion >4.0 cm in greatest dimension
IIB With obvious parametrial invasion
Stage III
The tumour extends to the pelvic wall and/or involves lower third of the vagina and/or causes hydronephrosis or non-functioning kidney
IIIA Tumour involves lower third of the vagina, with no extension to the pelvic wall
IIIB Extension to the pelvic wall and/or hydronephrosis or non-functioning kidney
Stage IV
The carcinoma has extended beyond the true pelvis or has involved (biopsy proven) the mucosa of the bladder or rectum. A bullous oedema, as such, does not permit a case to be allotted to Stage IV
IVA Spread of the growth to adjacent organs
IVB Spread to distant organs[1]

References

  1. ↑ Rosdahl, Caroline (2012). Textbook of basic nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 1550. ISBN 1605477729.

Diagrams

Treatment is individualised to the patient, her age, reproductive goals, functional status, and access to health care resources.

Treatment according to the FIGO stages of cervical carcinoma

Stage Ia1- therapeutic conization in young individuals, extrafascial hysterectomy in post reproductive age

Stage Ia2, Ib1, Ib2 and IIa- warthein's radical hysterectomy

Stage IIb, IIIa, IIIb and IVa- Generally chemoradiotherapy (cisplatin is used as radio sensitiser) is used. Surgery is not offered to this group of women because of the significant risk of positive margins and positive nodes.

Stage IVB and recurrent cancer- Palliative therapy (also depends on previously used treatments).

External links

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