Criteria for TNM Clinical Staging: Standard clinical staging for cervical carcinoma is that which is available at any community hospital. This includes physical examination and history, palpation of abdomen and pelvis, endocervical curettage, colposcopy, cystoscopy, proctoscopy, intravenous urography, hysteroscopy and imaging of the abdomen, lungs and bones. Additional procedures, such as laparoscopy, lymphangiography, venography and arteriography may better define the extent of the cancer, but should not influence staging.
Criteria for TNM Pathologic Staging: Pathologic review of resected specimens adds detailed staging information to the case, but should be recorded separately and should not be used to change the clinical staging.
Clinical staging is the preferred staging for cervical cancer. The clinical staging of cervical cancer should never be changed based on additional findings at surgery or later clinical findings.
Staging for cervical tumors applies only to carcinomas, not to sarcomas or other histologies.
|T1||I||Confined to uterus|
|T1a||IA||Diagnosed only by microscopy|
|T1a1||IA1||Depth = < 3 mm, horizontal spread = < 7 mm|
|T1a2||IA2||Depth > 3 to 5 mm, horizontal spread = < 7 mm|
|T1b||IB||Clinically visible or microscopic lesion, greater than T1a2|
|T1b1||IB1||= < 4 cm|
|T1b2||IB2||> 4 cm|
|T2||II||Beyond uterus but not pelvic wall or lower third of vagina|
|T2a||IIA||No parametrial involvement|
|T3||III||Lower third of vagina or pelvic wall or hydronephrosis|
|T3a||IIIA||Lower third of vagina|
|T4||IVA||Mucosa of bladder or rectum; beyond true pelvis|
Collaborative Stage Elements
For more details on Collaborative Stage, see the Intro to Collaborative Staging module.