GYN Onc Staging Flashcards
Staging for GTN (2009 FIGO)
Stage I
Disease confined to uterus
Staging for GTN (2009 FIGO)
Stage II
Disease outside the uterus but confined to genital structures (vagina, adnexa)
Staging for GTN (2009 FIGO)
Stage III
Metastasis to the lungs, with or without genital involvement
Staging for GTN (2009 FIGO)
Stage IV
Other metastatic sites (outside lungs and genital structures)
Staging for Cervical Cancer
Stage IA
Stage I: strictly confined to cervix
IA: invasive carcinoma that can be diagnosed with microscope only, maximum depth of invasion <5 mm
IA1: stromal invasion <3mm in depth
IA2: stromal invasion ≥3mm and <5mm in depth
Staging for Cervical Cancer (FIGO 2018)
Stage IB
IB: invasive carcinoma with measured deepest invasion ≥5mm, lesion limited to cervix
IB1: ≥5mm depth of stromal invasion, <2 cm
IB2: ≥2cm, <4cm in greatest dimension
IB3: ≥4cm in greatest dimension
Staging for Cervical Cancer (FIGO 2018)
Stage II (A and B)
Stage II: Carcinoma invades beyond uterus but not to pelvic wall or lower third of vagina
IIA: involvement limited to upper two thirds of vagina without parametrial involvement
IIA1: invasive carcinoma <4cm in greatest dimension
IIA2: invasive carcinoma ≥4cm in greatest dimension
IIB: with parametrial involvement, but not up to the pelvic wall
Staging for Cervical Cancer. (FIGO 2018)
Stage III
Stage III: carcinoma involves the lower third of the vagina and/or extends to the pelvic wall and/or causes hydronephrosis or non-functioning kidney and/or involves pelvic and/or para-aortic LNs
IIIA: carcinoma involves the lower third of the vagina, with no extension to pelvic wall
IIIB: Extension to the pelvic wall and/or hydronephrosis or non-functioning kidney (unless known to another cause)
IIIC: Involvement of pelvic and/or para-aortic LNs, irrespective of tumor size and extent
IIICr (LN metastasis on imaging) or IIICp (LN metastasis on pathology)
IIIC1: Pelvic LN only IIIC2: Para-aortic LN metastasis
Staging for Cervical Cancer (FIGO 2018)
Stage IV
Stage IV: extends beyond true pelvis or invades (biopsy proven) the mucosa of bladder or rectum
IVA: spread to adjacent pelvic organs
IVB: Spread to distant organs
Staging for Endometrial Cancer (FIGO)
Stage 1
(T1 for TNM)
Stage 1: tumor confined to corpus uteri, including cervical endocervical glandular involvement
IA (T1a): tumor limited to endometrium, invades <50% of myometrium
IB (T1b): Invades ≥ 50% myometrium
Staging for Endometrial Cancer (FIGO)
Stage II (T2)
Stage II (T2): Tumor invades stromal connective tissue of the cervix but does not extend beyond uterus (not including endocervical glandular involvement)
Staging for Endometrial Cancer (FIGO)
Stage III (T3)
Stage III (T3) - Tumor involving serosa, adnexa, vagina, or parametrium
IIIA (T3a) - tumor invades serosa, adnexa by direct extension or metastasis
IIIB (T3b) - vaginal involvement (direct extension or metastasis) or parametrial involvement
IIIC1 (N1)- metastatic to pelvic lymph nodes
(N1 mi)- LN mets >0.2 mm, <2mm in diameter
(N1a)- LN metastasis >2 mm in diameter
IIIC2 (N2)- metastatic to para-aortic lymph nodes
(N2 mi)- LN mets >0.2 mm, <2mm in diameter
(N2a)- LN metastasis >2 mm in diameter
Staging for Endometrial Cancer (FIGO)
Stage IVA (T4)
Stage IVA- Tumor invades bladder mucosa and/or bowel mucosa
Staging for Endometrial Cancer (FIGO)
Stage IVB (M1)
Stage IVB (M1): Distant metastasis including inguinal lymph nodes, interaperitoneal disease, lung, liver, or bone
Staging for Carcinoma of the Ovary (FIGO)
Stage I
Stage I: Tumor limited to ovaries or fallopian tubes
IA: Tumor limited to one ovary with capsule intact or fallopian tube, no tumor on ovarian or fallopian tube surface, no malignant cells in washings
IB: both ovaries with capsules intact or fallopian tubes, no tumor on surface, no malignant cells on washings
IC: limit to one or both ovaries with the following:
IC1: surgical spill
IC2: capsule ruptured before surgery or tumor on surface of ovaries/fallopian tubes
IC3: malignant cells in ascites or peritoneal washings
Staging for Carcinoma of the Ovaries (FIGO)
Stage II
Stage II: tumor involves one or both ovaries, fallopian tubes with pelvic extension below pelvic brim, or primary peritoneal cancer
Stage IIA: extension or implants on the uterus/ fallopian tubes and/or ovaries
Stage IIB: extension to or implants on other pelvic tissues
Staging for Carcinoma of the Ovaries (FIGO)
Stage III
Stage III: Tumor involves one or both ovaries, fallopian tubes or primary peritoneal cancer with microscopically confirmed peritoneal metastasis outside the pelvis and/or metastasis to retroperitoneal (pelvic and/or para-aortic) LNs
Stage IIIA:
1: positive LNs only
1i: mets ≤10 mm in dimension
1i: mets > 10 mm in dimension
2: microscopic extrapelvic peritoneal involvement +/- positive retroperitoneal LNs
Stage IIIB: macroscopic peritoneal metastasis beyond pelvis ≤2 cm in greatest dimension +/- metastasis to retroperitoneal LNs
Stage IIIC: peritoneal metastasis beyond pelvis ≥2 cm in dimension +/- retroperitoneal LNs (includes capsule of liver/ spleen without involvement of parenchyma)
Staging for Carcinoma of the Ovaries (FIGO)
Stage IV
Stage IV: Distant metastasis (not including peritoneal metastasis)
IVA: pleural effusion with positive cytology
IVB: Liver of splenic parenchymal metastases, inguinal LNs, LNs outside of abdominal cavity, transmural involvement of intestine
Vulvar Cancer (FIGO)
Stage I
Stage I: tumor confined to vulva or perineum
IA: tumor ≤2cm and stromal invasion <1mm
IB: size >2cm or any size with >1mm invasion
Vulvar Cancer (FIGO)
Stage II
Stage II: tumor of any size with adjacent spread (1/3 lower urethra, 1/3 lower vagina or anus), negative nodes
Vulvar Cancer (FIGO)
Stage III
IIIA: 1-2 LN metastasis each <5 mm
IIIB: ≥3 LN metastases each <5 mm
IIIC: LN metastases with extracapsular spread
Vulvar Cancer (FIGO)
Stage IV
Stage IVA: tumor of any size with any of the following: upper 2/3 urethra, upper 2/3 vagina, bladder mucosa or rectal mucosa or fixed to pelvic bone
Stage IVB: distant metastasis including pelvic LN
