Gynae Staging Flashcards
CERVIX Stage IA
Microscopy only. Limited to cervix uteri.
IA1 stromal invasion <3mm in depth
IA2 stromal invasion ≥3mm and <5mm in depth
CERVIX Stage IB
Limited to cervix uteri.
IB1 ≥5mm stromal invasion and <2cm in greatest dimension
IB2 ≥2cm and <4cm in greatest dimension
IB3 ≥4cm in greatest dimension
CERVIX Stage II A
Limited to upper 2/3 of vagina without parametrial involvement. No extension to lower third of vagina or pelvic wall.
IIA1 <4cm in greatest dimension
IIA2 ≥4cm in greatest dimension
CERVIX Stage II B
No extension to lower third of vagina or pelvic wall.
Parametrial involvement
CERVIX Stage III A
Involves lower third of the vagina with no extension to the pelvic wall
CERVIX Stage III B
Extension to pelvic wall and/or hydronephrosis or non-functioning kidney (unless another cause)
CERVIX Stage III C
Involvement of pelvic and/or para-aortic lymph nodes
IIIC1 pelvic LN mets only
IIIC2 para-aortic lymph node mets
CERVIX Stage IV
Extended beyond true pelvis, or involves (bx proven) mucosa of bladder or rectum
IV A = adjacent pelvic organs
IV B = spread to distant organs
Endometrium Stage I
Confined to uterus
IA < 1/2 myometrium involvement
IB ≥1/2 myometrium involvement
Endometrium Stage II
Tumour invades cervical stroma but does not extend beyond uterus (endocervix consider Stage I not Stage II)
Endometrium Stage III
IIIA Invades serosa of corpus uteri and/or adnexae
IIIB Vaginal and/or parametrial involvement
IIIC Mets to pelvic and/or para-aortic lymph nodes
IIIC1 positive pelvic nodes
IIIC2 positive para-aortic lymph nodes with or without positive pelvic lymph nodes
Endometrial Stage IV
IVA Invades bladder and/or bowel mucosa
IVB Distant mets including intra-abdominal and/or inguinal lymph nodes
Ovarian Stage IA
Limited to 1 ovary, capsule intact, no tumour on surface, negative washings
Ovarian Stage IB
Involves both ovaries, capsule intact, no tumour on surface, negative washings
Ovarian Stage IC
Limited to one or both ovaries
ICI surgical spill
IC2 capsule rupture before surgery or tumour on ovarian surface
IC3 malignant cells in ascites or peritoneal washing
Ovarian Stage II A
Involves 1 or both ovaries with pelvic extension below pelvic brim or primary peritoneal ca.
Extension and/or implant on uterus and/or fallopian tubes
Ovarian Stage II B
Involves 1 or both ovaries with pelvic extension below pelvic brim or primary peritoneal ca.
Extension to other pelvic intraperitoneal tissues
Ovarian Stage III A
III A1 Positive retroperitoneal LN only
i) mets ≤ 10mm
II) mets > 10mm
III A2 Microscopic extrapelvic (above the brim) peritoneal involvement +/- retroperitoneal lymph nodes
Ovarian Stage III B
Macroscopic, extra pelvic, peritoneal metastasis ≤2cm +/- positive retroperitoneal nodes. Includes extension to capsule of liver/ spleen
Ovarian Stage III C
Macroscopic, extra pelvic, peritoneal metastasis >2cm +/- positive retroperitoneal lymph nodes. Includes extension to capsule of liver/ spleen
Ovarian Stage IV A
Pleural Effusion with positive cytology
Ovarian Stage IV B
Hepatic and/or splenic parenchymal mets
Mets to extra-abdominal organs, including inguinal lymph nodes and lymph nodes outside of the abdominal cavity.
Vagina Stage I
Limited to wall of vagina
Vagina Stage II
Involved sub-vaginal tissue, but not extended to pelvic wall
Vagina Stage III
Carcinoma has extended to pelvic wall
Vagina Stage IV A
Invades bladder and/or rectal mucosa and/ or direct extension beyond the true pelvis (bullous oedema does not count)
Vagina Stage IV B
Spread to distant organs
Vulva Stage IA
Confined to vulva or perineum
Lesions ≤ 2cm,
Stromal invasion ≤1mm
Vulva Stage IB
Confined to vulva or perineum
Lesions > 2cm
Stromal invaion >1mm
Vulva Stage II
Any size
Extension to perineal structures
1/3 lower urethra
1/3 lower vagina, anus
Vulva Stage III A
i) 1 LN met ≥ 5mm
ii) 1-2 LN met < 5mm
Vulva Stage III B
i) 2 or more LN mets ≥5mm
ii) 3 or more LN mets <5mm
Vulva Stage III C
Positive nodes with ECS
Vulva Stage IV A
i) Invades 2/3 upper urethra and/ or 2/3 upper vagina
Bladder mucosa
Rectal mucosa
Fixed to pelvic bone
or
ii) fixed or ulcerated inguino-femoral lymph nodes
Vulva Stage IV B
Any distant mets including pelvic lymph nodes
