1. Rules for Classification
The classification applies only to primary carcinomas of the vulva. There should be histological confirmation of the disease.
A carcinoma of the vulva that has extended to the vagina is classified as carcinoma of the vulva.
The following are the procedures for assessing T, N, and M categories:
T categories. Physical examination, endoscopy, and imaging
N categories. Physical examination and imaging
M categories. Physical examination and imaging
The FIGO stages are based on surgical staging. (TNM stages are based on clinical and/or pathological classification.)
2. Regional Lymph Nodes
The regional lymph nodes are the femoral and inguinal nodes.3. TNM Clinical Classification
3.1. T - Primary TumourTX. Primary tumour cannot be assessed
T0. No evidence of primary tumour
Tis. Carcinoma in situ (preinvasive carcinoma)
T1. Tumour confined to vulva or vulva and perineum, 2 cm or less in greatest dimension
T1a. Tumour confined to vulva or vulva and perineum, 2 cm or less in greatest dimension and with stromal invasion no greater than 1 mm*
T1b. Tumour confined to vulva or vulva and perineum, 2 cm or less in greatest dimension and with stromal invasion greater than 1 mm*
T2. Tumour confined to vulva or vulva and perineum, more than 2 cm in greatest dimension
T3. Tumour invades any of the following: lower urethra, vagina, anus
T4. Tumour invades any of the following: bladder mucosa, rectal mucosa, upper urethra; or is fixed to pubic bone
3.2. N - Regional Lymph Nodes
NX. Regional lymph nodes cannot be assessed
N0. No regional lymph node metastasis
N1. Unilateral regional lymph node metastasis
N2. Bilateral regional lymph node metastasis
3.3. M - Distant Metastasis
MX. Distant metastasis cannot be assessed
M0. No distant metastasis
M1. Distant metastasis (including pelvic lymph node metastasis)
4. pTNM Pathological Classification
The pT, pN, and pM categories correspond to the T, N, and M categories.pN0. Histological examination of an inguinal lymphadenectomy specimen will ordinarily include 6 or more lymph nodes. If the lymph nodes are negative, but the number ordinarily examined is not met, classify as pN0.
5. G Histopathological Grading
See definitions on .6. Stage Grouping
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7. Summary
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