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