Cervical cancer staging

Updated on Jan 04, 2024

Edit

Comment

Cervical cancer staging is the assessment of cervical cancer to decide how far the disease has progressed. Cancer staging generally runs from stage 0, which is pre-cancerous or non-invasive, to stage 4, in which the cancer has spread throughout a significant part of the body. As a general rule, Stage 0 is easily cured and Stage 4 is incurable.

Cervical cancer is staged by the International Federation of Gynecology and Obstetrics (FIGO) staging system, which is based on clinical examination, rather than surgical findings. It allows only the following diagnostic tests to be used in determining the stage: palpation (feeling with the fingers), inspection, colposcopy, endocervical curettage, hysteroscopy, cystoscopy, proctoscopy, intravenous urography, and X-ray examination of the lungs and skeleton, and cervical conization.

Stage 0

The carcinoma is confined to the surface layer (cells lining) of the cervix. Also called carcinoma in situ (CIS).

Stage I

The carcinoma has grown deeper into the cervix, but has not spread beyond it (extension to the corpus would be disregarded). Stage One is subdivided as follows:

Stage II

Cervical carcinoma invades beyond the uterus, but not to the pelvic wall or to the lower third of the vagina

Stage III

The tumour extends to the pelvic wall and/or involves lower third of the vagina and/or causes hydronephrosis or non-functioning kidney

Stage IV

The carcinoma has extended beyond the true pelvis or has involved (biopsy proven) the mucosa of the bladder or rectum. A bullous oedema, as such, does not permit a case to be allotted to Stage IV

Treatment

Treatment is individualised to the patient, her age, reproductive goals, functional status, and access to health care resources.

Treatment according to the FIGO stages of cervical carcinoma:

Stage Ia1: therapeutic conization in young individuals, extrafascial hysterectomy in post reproductive age

Stage Ia2, Ib1, Ib2 and IIa: warthein's radical hysterectomy

Stage IIb, IIIa, IIIb and IVa: Generally chemoradiotherapy (cisplatin is used as radio sensitiser) is used. Surgery is not offered to this group of women because of the significant risk of positive margins and positive nodes.

Stage IVB and recurrent cancer: Palliative therapy (also depends on previously used treatments).

References

Cervical cancer staging Wikipedia

(Text) CC BY-SA