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RADT 210 Pelvis Module > Staging - Cervical Cancer > Flashcards

Staging - Cervical Cancer Flashcards

1
Q

What staging is used for gynae cancers?

A

FIGO (The International Federation of Gynaecology and Obstetrics 1974) - unusual to see TNM staging

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2
Q

Stage 1 description

A

The carcinoma is strictly confined to the cervix uteri (extension to the corpus should be disregarded)

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3
Q

Stage 1 - IA description

A

Invasive carcinoma that can be diagnosed only by microscopy, with a maximum depth of invasion <5mm

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4
Q

Stage 1 - IA1 description

A

Measured stromal invasion <3mm in depth

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5
Q

Stage 1 - IA2 description

A

Measured stromal invasion >3mm (inclusive) and <5mm in depth

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6
Q

Stage 1 - IB description

A

Invasive carcinoma with measured deepest invasion >5mm (inclusive) - greater than stage IA, lesion limited to the cervix uterine

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7
Q

Stage 1 - IB1 description

A

Invasive carcinoma >5mm (inclusive) depth of stromal invasion and <2cm in greatest dimension

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8
Q

Stage 1 - IB2 description

A

Invasive carcinoma >2cm (inclusive) depth of stromal invasion and <4cm in greatest dimension

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9
Q

Stage 1 - IB3 description

A

Invasive carcinoma >4cm (inclusive) in greatest dimension

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10
Q

Stage 2 description

A

The carcinoma invades beyond the uterus, but has not extended into the lower third of the vagina or pelvic wall

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11
Q

Stage 2 - IIA description

A

Involvement limited to the upper two-thirds of the vagina without parametrial involvement

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12
Q

Stage 2 - IIA1 description

A

Invasive carcinoma <4cm in greatest dimension

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13
Q

Stage 2 - IIA2 description

A

Invasive carcinoma >4cm (inclusive) in greatest dimension

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14
Q

Stage 2 - IIB

A

With parametrial involvement but not up to the pelvic wall

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15
Q

Stage 3 description

A

The carcinoma involves the lower third of the vagina and/or extends into he pelvic wall and/or causes hydronephrosis or non-functioning kidney and/or involves pelvic and/or paraaortic lymph nodes

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16
Q

Stage 3 - IIIA description

A

Carcinoma involves the lower third of the vagina, with no extension into the pelvic wall

17
Q

Stage 3 - IIIB description

A

Extension into the pelvic wall and/or the hydronephrosis or non-functioning kidney (unless known to be due to another cause)

18
Q

Stage 3 - IIIC description

A

Involvement of pelvic and/or paraaortic lymph nodes, irrespective of tumour size and extent

19
Q

Stage 3 - IIIC1 description

A

Pelvic lymph node metasteses only

20
Q

Stage 3 - IIIC2 description

A

Paraaortic lymph mestasteses

21
Q

Stage 4 description

A

The carcinoma has extended beyond the true pelvis and has involved (biopsy proven) the mucosa of the bladder or rectum. A bulls edema does not permit a case to be allotted to the stage 4

22
Q

Stage 4 - IVA description

A

Spread of growth to adjacent organs

23
Q

Stage 4 - IVB description

A

Spread of growth to distant organs

24
Q

As disease advances, it spreads in 3 main directions, what are these?

A

Adjacent stuctures
Along epithelial cells of the uterus
Through interstitial spaces of parametric tissue

25
Q

Cervical spread superiorly

A

Spread into the uterine body

26
Q

Cervical spread inferiorly

A

Into the vaginal vault

27
Q

Cervical spread laterally

A

Into the parametria and on to the lateral walls of the true pelvis

28
Q

Cervical spread anteriorly

A

To base of the bladder

29
Q

Cervical spread posteriorly

A

To rectum

30
Q

What can local disease progression result in?

A

Compression of ureters

31
Q

What is the percentage of lymphatic spread in stage IB (tumour confined to the cervix)?

A

20%

32
Q

What is the percentage of lymphatic spread in stage III (tumour extends to the lower 1/3rd of vagina and/or pelvis sidewalls)

A

60%

33
Q

What are the 2 main groups of lymph nodes in the female pelvis?

A

Internal iliac nodes
Perivesical lymph nodes

34
Q

What are the 3 nodes within the internal iliac nodes?

A

Superior gluteal
Inferior gluteal
Sacral

35
Q

What are the 3 nodes with the perivesical lymph nodes?

A

Pre vesicular
Post vesicular
Lateral vesicular

36
Q

What are the other 3 nodes in the pelvis?

A

Parauterine
Paravaginal
Anorectal (pararectal)

37
Q

Where and in what order does lymphatic invasion spread to?

A

Paracervical
Parametrial
Obturator
Internal, external and common iliac nodes
Lateral sacral nodes
Para-aortic nodes

38
Q

Worst prognostic factors

A

Tumour bulk <4cm
Presence of lymph node spread
Poorly differentiated tumours
Parametrial involvement
Other co-morbidites

RADT 210 Pelvis Module (7 decks)

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