Vaginal Cancer Stages

After a woman is diagnosed with vaginal cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Doctors also use a cancer's stage when talking about survival statistics.

Vaginal cancer stages range from stage I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more. Although each person’s cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated in much the same way.

How is the stage determined?

The 2 systems used for staging vaginal cancer, the FIGO (International Federation of Gynecology and Obstetrics) system and the AJCC (American Joint Committee on Cancer TNM staging system) are basically the same.

They both use 3 key pieces of information to stage (classify) this cancer :

• The extent (size) of the tumor (T): How large is the cancer and has it grown into the vaginal wall? Has the cancer reached nearby structures like the wall of the pelvis? (The pelvis is the internal cavity that contains the internal female reproductive organs, rectum, bladder, and parts of the large intestine.)
• The spread to nearby lymph nodes (N): Has the cancer spread to the lymph nodes in the pelvis or groin (inguinal) area?
• The spread (metastasis) to distant sites (M): Has the cancer spread to distant lymph nodes or distant organs?

Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. Once a person’s T, N, and M categories have been determined, this information is combined in a process called stage grouping to assign an overall stage.

The staging system in the table primarily uses the clinical stage. This is based on the results of a physical exam, biopsy, and imaging tests done before surgery. Surgical staging is determined by examining tissue removed during an operation. For more on this, see Cancer Staging.

The system described below is the most recent AJCC system, effective as of January 2018.

These systems are not used to stage vaginal melanoma, which is staged like melanoma of the skin. Information about melanoma staging can be found in Melanoma Skin Cancer.

Vaginal cancer staging can be complex, so ask your doctor to explain it to you in a way you understand.

AJCC Stage	Stage grouping	FIGO Stage	Stage description*
IA	T1a N0 M0	I	The cancer is only in the vagina and is no larger than 2 cm (4/5 inch) (T1a). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IB	T1b N0 M0	I	The cancer is only in the vagina and is larger than 2.0 cm (4/5 inch) (T1b). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IIA	T2a N0 M0	II	The cancer has grown through the vaginal wall, but not as far as the pelvic wall and is no larger than 2.0 cm (4/5 inch) (T2a). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IIB	T2b N0 M0	II	The cancer has grown through the vaginal wall, but not as far as the pelvic wall and is larger than 2.0 cm (4/5 inch) (T2b). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
III	T1 to T3 N1 M0	III	The cancer can be any size and might be growing into the pelvic wall and/or has blocked the flow of urine (hydronephrosis) which is causing the kidneys to not work. (T1 to T3). It has also spread to nearby lymph nodes in the pelvis or groin (inguinal) area (N1) but not distant sites (M0).
	OR
	T3 N0 M0	III	The cancer is growing into the pelvic wall and/or has blocked the flow of urine (hydronephrosis) which is causing the kidneys to not work. (T3). It has not spread to nearby lymph nodes (N0) or to distant sites (M0).
IVA	T4 Any N M0	IVA	The cancer is growing into the bladder or rectum or is growing out of the pelvis (T4).  It might or might not have spread to lymph nodes in the pelvis or groin (inguinal area) (Any N).  It has not spread to distant sites (M0).
IVB	Any T Any N M1	IVB	The cancer has spread to distant organs such as the lungs, liver, or bones. (M1). It can be any size and might or might not have grown into nearby structures or organs (Any T). It might or might not have spread to nearby lymph nodes (Any N).

The following additional categories are not listed in the table above:

• TX: Main tumor cannot be assessed due to lack of information.
• T0: No evidence of a primary tumor.
• NX: Regional lymph nodes cannot be assessed due to lack of information.