Staging

The FIGO staging system is based predominantly on the extent of the primary tumour. Metastatic spread is normally by the lymphatic system and tends to be sequential—to the parametrial nodes, the obturator

Table 23.3 FIGO staging system for cervical cancer

Stage

Definition

Ia

Micro-invasive disease (max depth 5 mm, max width 7 mm)

Ib

Clinical disease confined to the cervix

IIa

Disease involves upper 1/3 vagina but not parametrium

IIb

Disease involves parametrium but does not extend to pelvic wall

III

Disease involves lower 2/3 vagina and/or pelvic wall

IV

Involvement of bladder, rectum, or distant organs

group, the internal then common iliacs, and on through the para-aortics to the left neck. Systemic metastases are rare outside the chest.

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