Cervical cancer diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[2], Monalisa Dmello, M.B,B.S., M.D. [3]

Overview

Cervical cancer is staged by the International Federation of Gynecology and Obstetrics (FIGO) staging system, which is based on clinical examination, cost effective imaging studies and gynecologyocal procedures such as hysteroscopy and cystoscopy, this is important to detect survival rates in women with cervical cancer. The advantage of newly revised 2018 FIGO is that it can be used in lower income countries as well since expensive surgical procedures are avoided in this staging sysytem.

Staging

FIGO Stage Groupings and Definitions

The revised 2018 FIGO staging system for cervical cancer is useful to distinguish survival groups based on their distinct charracteristics and outcome.[1][2]

Stage I- The carcinoma is strictly confined to the cervix (extension to the uterine corpus should be disregarded)

  • IA -Invasive cancer identified only microscopically. (All gross lesions even with superficial invasion are Stage IB cancers.) Invasion is limited to measured stromal invasion with a maximum depth of 5 mmband no wider than 7 mm
  • IA1 - Measured invasion of stroma ≤3.0 mm in depth and ≤7.0 mm width
  • IA2 - Measured invasion of stroma >3.0 mm and < 5.0 mm in depth and ≤ 7 mm width
  • IB - Clinical lesions confined to the cervix or preclinical lesions greater than stage IA
  • IB1 - Clinical lesions no greater than 4 cm in size
  • IB2 - Clinical lesions >4 cm in size

Stage II -The carcinoma extends beyond the uterus but not extended onto the pelvic wall or to the lower third of the vagina.

  • IIA- Involvement of up to the upper 2/3 of the vagina. No obvious parametrial involvement
  • IIA1 - Clinically visible lesion ≤4.0 cm
  • IIA2 - Clinically visible lesion >4.0 cm

Stage III - The carcinoma has extended onto the pelvic sidewall. On rectal examination, there is no cancer-free space between the tumor and pelvic sidewall. The tumor involves the lower third of the vagina. All cases of hydronephrosis or nonfunctioning kidney should be included unless they are known to be due to other causes

Stage IV The carcinoma has extended beyond the true pelvis or has clinically involved the mucosa of the bladder and/or rectum

  • IVA - Spread to adjacent pelvic organs
  • IVB - Spread to distant organs

References

  1. Freeman, Susan J.; Aly, Ahmed M.; Kataoka, Masako Y.; Addley, Helen C.; Reinhold, Caroline; Sala, Evis (2012). "The Revised FIGO Staging System for Uterine Malignancies: Implications for MR Imaging". RadioGraphics. 32 (6): 1805–1827. doi:10.1148/rg.326125519. ISSN 0271-5333.
  2. http://www.cancer.gov/types/cervical/hp/cervical-treatment-pdq#section/_11

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