|
|
|
|
|
|
|
|
4.4 Staging
1) Classification Criteria(FIGO/UICC 1997)
| TNM |
FIGO |
|
| TX |
|
Primary tumour cannot be assessed |
| T0 |
|
No evidence of primary tumour |
| TIS |
0 |
Carcinoma in situ (preinvasive carcinoma) |
| T1 |
I |
Cervical carcinoma confined to uterus (extension to corpus should be disregarded) |
| T1a |
IA |
Invasive cancer identified only microscopically. All gross lesions even with superficial invasion are stage T1b/IB cancers. |
| T1a1 |
IA1 |
Stromal invasion no greater than 3.0 mm in depth and no wider than 7.0 mm |
| T1a2 |
IA2 |
Measured invasion of stroma greater than 3.0 mm and no greater than 5.0 mm with horizontal spread 7.0 mm or less |
| Note: The depth of invasion should not be more than 5 mm taken from the base of the epithelium, either surface or glandular, from which it originates. Vascular space involvement, either venous or lymphatic, should not alter the staging, but should be specifically recorded so as to determine whether it should affect treatment decisions in the future. |
| T1b |
IB |
Clinical lesions confined to the cervix or microscopic lesion greater than T1a2/IA2 |
| T1b1 |
IB1 |
Clinical lesions not greater than 4.0 cm in size |
| T1b2 |
IB2 |
Clinical lesions greater than 4.0 cm in size |
| T2 |
II |
Tumour invades beyond uterus but not to pelvic wall or to lower third of the vagina |
| T2a |
IIA |
Without parametrial invasion |
| T2b |
IIB |
With parametrial invasion |
| T3 |
III |
Tumour extends to pelvic wall and/or involves lower third of vagina and/or causes hydronephrosis or non-functioning kidney |
| T3a |
IIIA |
Tumour involves lower third of vagina, no extension to pelvic wall |
| T3b |
IIIB |
Tumour extends to pelvic wall and/or causes hydronephrosis or non-functioning kidney |
| T4 |
IVA |
Tumour invades mucosa of bladder or rectum and/or extends beyond true pelvis
Note: the presence of bullous edema is not sufficient to classify a tumour as T4 |
| M1 |
IVB |
Distant metastasis |
2) Staging Diagram
 |
|
Click image
for larger version |
3) Investigations for Staging
Following biopsy confirmation of carcinoma of the cervix, history and physical examination and staging, the following lab and radiological studies should be done:
- Lab studies: CBC, differential, platelet count, BUN and creatinine, liver function tests and
- Cystoscopy, sigmoidoscopy
- Radiological studies: Chest X-ray, CT scan of the abdomen and pelvis.
Referral, however, should not be delayed.
|
|
|