Deborah CM Boyle
Laszlo Ungars Giuseppe Del Priore J Richard Smith
The traditional management of invasive cervical carcinoma has naturally depended on the stage of
Table 1 The Federation Internationale de Gynécologie et d'Obstétrique (FIGO) staging of cervical cancer
0 Intraepithelial neoplasia
1 The carcinoma is strictly confined to the cervix; extension to the uterine corpus should be disregarded
IA Preclinical carcinomas of the cervix (i.e. those diagnosed by microscopy only). All gross lesions even with superficial invasion are stage IB. Invasion is limited to measured stromal invasion with a maximum depth of 5 mm and no wider than 7 mm. Measurement of the depth of invasion should be from the base of the epithelium, either surface or glandular, from which it orinates. Vascular space involvement, either venous or lymphatic, should not alter the staging
IA 1 Minimal microscopically evident stromal invasion. The stromal invasion is no more than 3 mm deep and no more than 7 mm in diameter
IA2 Lesions detected microscopically that can be measured. The measured invasion of the stroma is deeper than 3 mm but no greater than 5 mm, and the diameter is no wider than 7 mm
IB Clinical lesions confined to the cervix, or preclinical lesions greater than stage IA.
IB1 Clinical lesions not greater than 4 cm in size
IB2 Clinical lesions greater than 4 cm in size
II Involvement of the vagina except the lower third, or infiltration of the parametrium. No involvement of the pelvic side-wall
IIA Involvement of the upper two-thirds of the vagina, but not out to the side-wall
IIB Infiltration of the parametrium, but not out to the side-wall
III Involvement of the lower third of the vagina. Extension to the pelvic side-wall. On rectal examination there is no cancer-free space between the tumour and the pelvic side-wall. All cases with a hydronephrosis or nonfunctioning kidney should be included, unless this is known to be attributable to another cause
IIIA Involvement of the lower third of the vagina, but not out to the pelvic side-wall if the parametrium is involved.
IIIB Extension onto the pelvic side-wall and/or hydronephrosis or nonfunctional kidney ,
IV Extension of the carcinoma beyond the reproductive tract
IVA Involvement of the mucosa of the bladder or rectum
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