Staging is based on surgico-pathological findings.
Stage 0
TIS Carcinoma in situ; intraepithelial carcinoma.
Stage I
T1 N0 M0 Tumour confined to the vulva and/or perineum, 2 cm or less in
greatest dimensions, nodes are negative.
Stage IA
Lesions 2 cm or less in size confined to the vulva or perineum with
stromal invasion no greater than 1.0 mm. No nodal metastases. The depth
of invasion is defined as the measurement of the tumour from the
epithelial-stromal junction of the adjacent most superficial dermal
papilla to the deepest point of invasion.
Stage IB
Lesions 2 cm or less in size confined to the vulva or perineum with
stromal invasion greater than 1.0 mm. No nodal metastases.
Stage II
T2 N0 M0 Tumour confined to the vulva and/or perineum, more than 2 cm
in greatest dimension, nodes are negative.
Stage III
T3 N0 M0 Tumour of any size with:
- T3 N1 M0 1) Adjacent spread to lower urethra and/or vagina, or the
anus and/or,
- T1 N1 M0 2) Unilateral regional lymph node metastasis.
T2 N1 M0
Stage IV
Stage IVA
T1 N2 M0 Tumour invades any of the following:
- T2 N2 M0 Upper urethra, bladder mucosa, rectal mucosa, pelvic bone
and/or bilateral regional groin node metastasis.
- T3 N2 M0
T4 any N M0
Stage IVB
Any T, any N, M1 Any distant metastasis including pelvic lymph nodes.
TMN Classification of Carcinoma of the Vulva (FIGO)
T Primary tumour
Tis Preinvasive carcinoma (carcinoma-in-situ)
T1 Tumour confined to vulva and/or perineum <2 cm in greatest
dimension
T2 Tumour confined to vulva and/or perineum >2 cm in greatest
dimension
T3 Tumour of any size with adjacent spread to the urethra and/or vagina
and/or the anus
T4 Tumour of any size infiltrating the bladder mucosa and/or the rectal
mucosa, including the upper part of the urethral mucosa and/or fixed to
the bone.
N Regional lymph nodes
N0 No lymph node metastasis.
N1 Unilateral regional lymph node metastasis.
N2 Bilateral regional lymph node metastasis.
M Distant Metastasis
M0 No clinical metastasis.
M1 Distant metastasis (including pelvic lymph node metastasis).
Dr James L. Nicklin
M.B., B.S. (Qld),
F.R.A.C.O.G., C.G.O
Gynaecologic
Oncologist
Queensland Centre for Gynaecological Cancer
