Carcinoma Cervix

The TNM staging system for cervical cancer is analogous to the FIGO stage.

• Stage 0 – full-thickness involvement of the epithelium without invasion into the stroma (carcinoma in situ)
  


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  Stage I – limited to the cervix
  
  
  
  
  
  • 
    
    IA – diagnosed only by microscopy; no visible lesions
    
    
    
    
    
    • IA1 – stromal invasion less than 3 mm in depth and 7 mm or less in horizontal spread
      
    
    
    • IA2 – stromal invasion between 3 and 5 mm with horizontal spread of 7 mm or less
      
    
    
    
    
  
  
  • 
    
    IB – visible lesion or a microscopic lesion with more than 5 mm of depth or horizontal spread of more than 7 mm
    
    
    
    
    
    • IB1 – visible lesion 4 cm or less in greatest dimension
      
    
    
    • IB2 – visible lesion more than 4 cm
      
    
    
    
    
  
  
  
  


• 
  
  Stage II – invades beyond cervix
  
  
  
  
  
  • IIA – without parametrial invasion, but involve upper 2/3 of vagina
    
  
  
  • IIB – with parametrial invasion
    
  
  
  
  


• 
  
  Stage III – extends to pelvic wall or lower third of the vagina
  
  
  
  
  
  • IIIA – involves lower third of vagina
    
  
  
  • IIIB – extends to pelvic wall and/or causes hydronephrosis or non-functioning kidney
    
  
  
  
  

Stage IV-Distant spread

• IVA – invades mucosa of bladder or rectum and/or extends beyond true pelvis
  


• IVB – distant metastasis
  

Key Points:4stages, each having two subdivisions A and B.No mention of LN status,Ascites.


Treatment


Tumour <5mm-Conization(to preserve fertility)or hysterectomy


Invasive lesions not extending to abdominal viscera or distal vagina-Hysterectomy+Chemotherapy+Radiotherapy


Recurrent disease- Radiotherapy.

Related articles

• Cancer of the Cervix