Clinical staging of cervical cancer

The clinical staging of cervical cancer is of great significance for determining treatment plans, unifying efficacy comparisons and estimating prognosis. However, since the scope of lesion extension and metastasis is mainly understood by double-handed examination, it is often affected by personal experience and subjective factors, and there will be certain discrepancies. If combined with surgical pathology staging, a more objective and reliable judgment of the condition can be made.

The clinical staging method has been revised several times since the International Society of Oncology and the International Federation of Gynecology and Obstetrics established the cervical cancer staging standards in 1929. The international staging method currently used is the one revised by FIGO in 1970.

The Second National Cancer Conference of my country made some additional provisions for international staging:

Stage 0 (carcinoma in situ): The cancer is confined to the epithelium of the cervical mucosa or glandular epithelium.

Stage I: Clinical examination shows that the cancer has not expanded beyond the cervix. It is divided into four substages:

Ia: No cancerous mass was formed by naked eye observation, the ulcer surface was quite similar to cervical erosion, and the cervical canal did not harden.

Ib A cancer mass has formed, but the diameter of the mass does not exceed 1 cm.

The diameter of the Ic cancer mass is between 1 and 3 cm.

Id The cancer mass is larger than 3 cm or half the size of the cervix.

Stage II: Those with any of the following conditions are all stage II. The cancer has invaded the vagina but is still limited to the upper 2/3 of the vagina; the cancer has invaded the parauterine tissue (including the cardinal ligament and uterosacral ligament) but has not yet reached the pelvic wall; the uterine body has been invaded. Cancer that only invades the vaginal wall, or mainly invades the vaginal wall, is called vaginal type. Cancer that only invades the parauterine tissue, or mainly invades the parauterine tissue, is called parauterine type.

Ⅱa (early stage Ⅱ): ① the invasion of the vaginal vault does not exceed 2 cm; ② the invasion of the parauterine tissue is limited to the inner 1/3. Ⅱb (mid-stage Ⅱ): ① the invasion of the vagina has exceeded 2 cm, but is still limited to the upper 1/3; ② the invasion of the parauterine tissue has exceeded the inner 1/3, but is still limited to the inner 1/2.

IIc (late stage II): ① Vaginal invasion is limited to more than the middle 1/3 of the vaginal wall; ② The invasion of the parauterine tissue exceeds 1/2 but has not yet reached the pelvic wall; ③ The uterine body has been invaded.

Stage III patients meet one of the following conditions: ① The tumor has invaded the lower 1/3 of the vagina; ② The parauterine tissue has been affected to the pelvic wall.

Ⅲa (early stage Ⅲ): The parauterine tissue is infiltrated in a cord-like manner.

Ⅲb (late stage Ⅲ) The parauterine tissue is infiltrated in a mass-like manner.

Stage IV: Metastasis has occurred to other organs in the abdominal cavity, vulva, pelvic cavity, or other distant metastases.