Vulvar Cancer Stages / Staging

Stages of Vulvar Cancer 

Vulvar cancer staging describes how large a cancer is, and the degree to which the disease has spread. The staging guidelines developed by the International Federation of Gynecology and Obstetrics (FIGO) and the American Joint Committee on Cancer (AJCC) system are used to stage vulvar cancers. This common system allows doctors to communicate important information about the cancer with each other in a standardized way. Vulvar cancer stages are based on three categories:

• T – Describes the primary tumor size.
• N – Indicates whether the vulvar cancer cells have spread to regional lymph nodes.
• M – Refers to whether the cancer has metastasized (spread to distant areas of the body).

Vulvar Cancer Stage Groupings 

Once the individual TNM components are scored, they are combined to determine the overall stage group:

• Stage 0: This indicates an early-stage cancer restricted to the surface of the vulva. It may also be called "carcinoma in situ" or "Bowen disease." This stage is used only in the AJCC system, and not in the FIGO system.
• Stage I: The cancer is growing in the vulva and/or the perineum (the area between the anus and the opening of the vagina). The cancer has not spread to lymph nodes or other organs in the body.
  • Stage IA: These tumors are smaller than 2 cm and have invaded no deeper than 1 mm into the underlying tissue of the vulva.
  • Stage IB: These cancers are either larger than 2 cm or they have invaded deeper than 1 mm.
• Stage II: In this vulvar cancer stage, the disease has spread beyond the vulva and/or the perineum to the anus, the lower third of the vagina or the urethra. However, cancer cells have not spread to lymph nodes or other organs in the body.
• Stage IIIA: The cancer is growing in the vulva and/or the perineum and may have spread to the anus, the lower third of the vagina or the urethra. It has either spread to 1 nearby lymph node with a total tumor spread size greater than 5mm, or the total tumor spread is less than 5 mm, but cancer cells spread to  one to two nearby lymph nodes. The cancer cells have not metastasized, or spread, to distant areas of the body.
• Stage IIIB: In this stage of vulvar cancer, the disease is growing in the vulva and/or the perineum and may have spread to the anus, the lower third of the vagina or the urethra. It has either spread to three nearby lymph nodes with a total tumor spread size less than 5mm, or it has spread to at least two nearby lymph nodes, and the size of each area of spreading is 5 mm or more. The cancer cells have not metastasized to distant areas of the body.
• Stage IIIC: The cancer is growing in the vulva and/or the perineum and may have spread to the anus, the lower third of the vagina or the urethra. The cancer cells have spread to nearby lymph nodes, and have begun to grow outside of the covering layer of at least one lymph node. The cancer cells have not metastasized to distant areas of the body.
• Stage IVA: In this stage of vulvar cancer, the disease is growing in the vulva and/or the perineum and may have spread to the anus, the lower third of the vagina or the urethra. Either cancer cells have spread to nearby lymph nodes and have caused them to become attached to nearby tissues or to develop open sores, OR cancer cells have spread further to organs in the pelvis, such as the bladder, rectum, pelvic bone or upper part of the urethra. However, cancer cells have not yet reached distant organs.
• Stage IVB: Cancers at this stage are the most advanced. Cancer cells have reached distant organs or lymph nodes farther from the pelvis.

Vulvar Cancer Staging and Treatment Options 

There are a number of different treatment options for each stage of vulvar cancer. Your medical history and other relevant factors will be carefully reviewed by your care team at CTCA to develop a personalized treatment plan for you.

Next Topic: Vulvar Cancer Treatments