Page 14 - ESGO - Vulvar cancer - Complete report_fxd2

Table 1. Staging systems of squamous cell vulvar cancer

PRIMARY TUMOUR T

TNM categories5 FIGO stages6 Definition

TX IA Primary tumour cannot be assessed
T0 IB No evidence of primary tumour
Tis* II Carcinoma in situ
T1a Lesions ≤ 2 cm in size, confined to the vulva or perineum and with stromal invasion ≤ 1.0 mm**, no nodal metastasis
T1b Lesions > 2 cm in size or with stromal invasion > 1.0 mm*, confined to the vulva or perineum, with negative nodes
T2*** Tumour of any size with extension to adjacent perineal structures 1/3 lower urethra, 1/3 lower vagina, anus with
negative nodes
T3**** IVA Tumour invades upper urethral and/or vaginal mucosa, bladder mucosa, rectal mucosa, or fixed to pelvic bone

REGIONAL LYMPH NODES N

TNM categories5 FIGO stages6 Definition

NX IIIA Regional lymph nodes cannot be assessed
N0 IIIA No regional lymph node metastasis
N1 IIIB One or two regional lymph nodes with the following features
 N1a IIIB One or two node metastasises, each 5 mm or less
 N1b IIIB One lymph node metastasis 5 mm or greater
N2 IIIC Regional lymp node metastasis with the following features
 N2a IVA Three or more lymph node metastases each less than 5 mm
 N2b Two or more lymph node metastases 5 mm or greater
 N2c Lymph node metastasis with extracapsular spread
N3 Fixed or ulcerated regional lymph nodes

DISTANT METASTASIS M

TNM categories5 FIGO stages6 Definition
IVB
* No distant metastasis
Distant metastasis incluing pelvic lymph node metastasis
M0

M1

* FIGO no longer includes stage 0 Tis, ** 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, *** FIGO uses the classification T2/T3. This is defined as T2 in TNM, **** FIGO uses the
classification T4. This is defined as T3 in TNM.

 VULVAR CANCER - GUIDELINES 
14