Cervical Cancer Staging

Updated: Feb 25, 2022
Author: Cecelia H Boardman, MD; Chief Editor: Yukio Sonoda, MD 

TNM and FIGO Classifications for Cervical Cancer

The American Joint Committee on Cancer (AJCC) TNM classification and the International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer are provided below.[1, 2, 3]

Table 1. TNM and FIGO Classifications for Cervical Cancer (Open Table in a new window)

Primary tumor (T)

TNM

FIGO

Surgical-Pathologic Findings

Categories

Stages

 

TX

 

Primary tumor cannot be assessed

T0

 

No evidence of primary tumor

Tis

 

Carcinoma in situ (preinvasive carcinoma)

T1

I

Cervical carcinoma confined to the cervix (disregard extension to the corpus)

T1a

IA

Invasive carcinoma diagnosed only by microscopy; stromal invasion with a maximum depth of < 5.0 mm, measured from the base of the epithelium; vascular space involvement, venous or lymphatic, does not affect classification

 

T1a1

IA1

Measured stromal invasion < 3.0 mm in depth 

T1a2

IA2

Measured stromal invasion ≥ 3.0 mm and < 5.0 mm 

T1b

IB

Invasive carcinoma with measured deepest invasion ≥ 5 mm (greater than stage IA), lesion limited to the cervix 

T1b1

IB1

Invasive carcinoma with ≥ 5 mm depth of stromal invasion and < 2 cm in greatest dimension

T1b2

IB2

Invasive carcinoma, 2 cm to < 4 cm in greatest dimension

T1b3

IB3

Invasive carcinoma, ≥ 4 cm in greatest dimension

T2

II

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

T2a

IIA

Involvement limited to the upper two-thirds of the vagina, without parametrial invasion

T2a1

IIA1

Invasive carcinoma < 4 cm in greatest dimension

T2a2

IIA2

Invasive carcinoma ≥ 4 cm in greatest dimension

T2b

IIB

Tumor with parametrial invasion but not up to the pelvic wall

T3

III

Carcinoma involves the lower third of the vagina and/or extends to the pelvic wall and/or causes hydronephrosis or nonfunctioning kidney and/or involves pelvic and/or para-aortic lymph nodes

T3a

IIIA

Tumor involves lower third of vagina, with no extension to pelvic wall

T3b

IIIB

Tumor extends to pelvic wall and/or causes hydronephrosis or nonfunctional kidney

T3c

IIIC

Involvement of pelvic and/or para-aortic lymph nodes, irrespective of tumor size and extent (with r [imaging] and p [pathology] notations)

T3c1

IIIC1

Pelvic lymph node metastasis only

T3c2

IIIC2

Para-aortic lymph node metastasis

T4

IV

The carcinoma has extended beyond the true pelvis or has involved (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

Spread to adjacent pelvic organs

 

IVB

Spread to distant organs

Regional lymph nodes (N)

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N0 (i+)

Isolated tumor cells in regional lymph node(s) ≤ 0.2 mm

N1

Regional lymph node metastasis

Distant metastasis (M)

M0

No distant metastasis

M1

Distant metastasis (including peritoneal spread; involvement of supraclavicular, mediastinal, or distant lymph nodes; and lung, liver, or bone) 

Table 2. AJCC Prognostic Groups (Open Table in a new window)

Stage

Tumor

Node

Metastasis

I

T1

Any N

M0

IAI

T1a

Any N

M0

IA2

T1a1

Any N

M0

IB

T1b

Any N

M0

IB1

T1b1

Any N

M0

IB2

T1b2

Any N

M0

II

T2

Any N

M0

IIA

T2a

Any N

M0

IIA1

T2a1

Any N

M0

IIA2

T2a2

Any N

M0

IIB

T2b

Any N

M0

III

T3

Any N

M0

IIIA

T3a

Any N

M0

IIIB

T3b

Any N

M0

IVA

T4

Any N

M0

IVB

Any T

Any N

M1