FIGO Staging 2009/2014/2018
Stage I: tumor confined to the vulva
IA Lesions ≤2 cm in size, confined to the vulva or perineum and with stromal invasion ≤1.0 mm, no nodal metastasis
IB Lesions >2 cm in size or with stromal invasion >1.0 mm, confined to the vulva or perineum, with negative nodes
Stage II: tumor of any size with extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with negative nodes
Stage III: tumor of any size with or without extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with positive inguinofemoral lymph nodes
IIIA (i) with 1 lymph node metastasis (≥5 mm)
IIIA (ii) 1–2 lymph node metastasis(es) (<5 mm)
IIIB (i) with 2 or more lymph node metastases (≥5 mm)
IIIB (ii) 3 or more lymph node metastases (<5 mm)
IIIC with positive nodes with extracapsular spread
Stage IV: tumor invades other regional (2/3 upper urethra, 2/3 upper vagina), or distant structures
IVA (i) tumor invades any of the following: upper urethral and/or vaginal mucosa, bladder mucosa, rectal mucosa, or fixed to pelvic bone
IVA (ii) fixed or ulcerated inguino-femoral lymph nodes
IVB any distant metastasis including pelvic lymph nodes
Stage I: tumor confined to the vagina
Stage II: tumor invades paravaginal tissues but does not extend to pelvic wall
Stage III: tumor extends to pelvic wall† or regional (pelvic or inguinal) lymph node metastasis
Stage IV: tumor invades mucosa of the bladder or rectum (biopsy proven) or shows direct extension beyond the true pelvis; bullous edema is not sufficient to allow classification as Stage IV
IVA tumor invasion of bladder and/or bowel mucosa
IVB distant metastasis
† Pelvic wall is defined as muscle, fascia, neurovascular structures, or skeletal portions of the bony pelvis. On rectal examination, there is no cancer-free space between the tumor and pelvic sidewalls
Stage I: tumor strictly confined to the cervix (extension to the corpus would be disregarded)
IA diagnosed only by microscopy, with deepest invasion <5 mm
IA1 measured stromal invasion of <3.0 mm in depth
IA2 measured stromal invasion of ≥3.0 mm and <5.0 mm in depth
IB clinically visible lesion limited to the cervix uteri or preclinical cancers ≥5 mm in depth (greater than stage IA)
IB1 invasive carcinoma ≥5 mm depth of stromal invasion, and <2 cm in greatest dimension
IB2 invasive carcinoma ≥2 cm and <4 cm in greatest dimension
IB3 invasive carcinoma ≥4 cm in greatest dimension
Stage II: tumor invades beyond the uterus, but not to the pelvic wall or to the lower third of the vagina
IIA without parametrial invasion
IIA1 clinically visible lesion <4.0 cm in greatest dimension
IIA2 clinically visible lesion ≥4 cm in greatest dimension
IIB with obvious parametrial invasion
Stage III: tumor extends to the pelvic wall and/or involves lower third of the vagina and/or causes hydronephrosis or non-functioning kidney and/or involves pelvic and/or para-aortic lymph nodes
IIIA tumor 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 (unless known to be due to another cause)
IIIC involvement of pelvic and/or para-aortic lymph nodes, irrespective of tumor size and extent (either radiographic (r) or histologic (p))
IIIC1 pelvic lymph node metastasis only
IIIC2 para-aortic lymph node metastasis
Stage IV: tumor extends beyond the true pelvis or involves (biopsy proven) the mucosa of the bladder or rectum. A bullous edema, as such, does not permit a case to be allotted to Stage IV
IVA tumor invasion of bladder and/or bowel mucosa
IVB distant metastases
Stage I: tumor confined to the corpus uteri
IA no or less than half myometrial invasion
IB invasion equal to or more than half of the myometrium
Stage II: tumor invades cervical stroma, but does not extend beyond the uterus
Stage III: local and/or regional spread of the tumor
IIIA tumor invades the serosa of the corpus uteri and/or adnexae
IIIB vaginal and/or parametrial involvement
IIIC metastases to pelvic and/or para-aortic lymph nodes
IIIC1 positive pelvic nodes
IIIC2 positive paraaortic lymph nodes with or without positive pelvic lymph nodes
Stage IV: tumor invades bladder and/or bowel mucosa, and/or distant metastases
IVA tumor invasion of bladder and/or bowel mucosa
IVB distant metastases, including intra-abdominal metastases and/or inguinal lymph nodes
Stage I: tumor confined to ovaries
IA tumor limited to one ovary, capsule intact, no tumour on ovarian surface, no malignant cells in the ascites or peritoneal washings
IB tumor limited to both ovaries, capsules intact, no tumour on ovarian surface, no malignant cells in the ascites or peritoneal washings
IC tumor limited to one or both ovaries, with any of the following: capsule ruptured, tumour on ovarian surface, positive malignant cells in the ascites or positive peritoneal washings
IC1 surgical spill
IC2 capsule rupture before surgery or tumor on ovarian surface
IC3 malignant cells in the ascites or peritoneal washings
Stage II: tumor involves one or both ovaries with pelvic extension
IIA extension and/or implants in uterus and/or tubes
IIB extension to other pelvic organ
Stage III: tumor involves one or both ovaries with microscopically confirmed peritoneal metastasis outside the pelvis and/or and/or regional lymph nodes metastasis
IIIA positive retroperitoneal lymph nodes and/or microscopic metastasis beyond the pelvis
IIIA1 positive retroperitoneal lymph nodes only
IIIA1(i) metastasis ≤ 10 mm
IIIA1(ii) metastasis > 10 mm
IIIA2 microscopic, extrapelvic peritoneal involvement ± positive retroperitoneal lymph nodes
IIIB macroscopic, extrapelvic peritoneal metastasis ≤ 2 cm ± positive retroperitoneal lymph nodes. includes extension to capsule of liver/spleen
IIIC macroscopic, extrapelvic peritoneal metastasis > 2 cm ± positive retroperitoneal lymph nodes. includes extension to capsule of liver/spleen
Stage IV: distant metastasis beyond the peritoneal cavity. If pleural effusion is present, there must be positive cytology to allot a case to stage IV. Parenchymal liver metastasis equals stage IV
IVA pleural effusion with positive cytology
IVB hepatic and/or splenic parenchymal metastasis, metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside of the abdominal cavity)
Stage I: *tumor limited to uterus
IA less than 5 cm
IB greater than or equal to 5 cm
Stage II: tumor extends to the pelvis
IIA adnexal involvement
IIB tumor extends to extrauterine pelvic tissue
Stage III: tumor invades abdominal tissues (not just protruding into the abdomen)
IIIA one site
IIIB more than one site
IIIC metastasis to pelvic and/or para-aortic lymph nodes
Stage IV: tumor invades bladder and/or rectum and/or distant metastasis
IVA tumor invades bladder and/or rectum
IVB distant metastasis
*Two different substagings for LMS/ESS and adenosarcomas
Carcinosarcomas should be staged as carcinomas of the corpus uteri