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The process of finding out how far the cancer has spread is called
staging. Information is gathered from exams and diagnostic tests to determine
the size of the tumor, how deeply the tumor has invaded tissues within and
around the cervix, and the spread to lymph nodes or distant organs
(metastasis). This is an important process because the stage of the cancer is
the key factor in selecting the right treatment plan.
A staging system is a way for members of the cancer care team to summarize
the extent of a cancer's spread. Cervical cancer is staged with the FIGO
(International Federation of Gynecology and Obstetrics) System of Staging.
This system classifies the disease in stages 0 through IV. It is based on
clinical staging rather than surgical staging. This means that the extent of
disease is evaluated by the doctor's physical examination and a few other
tests that are done in some cases, such as cystoscopy and proctoscopy.
If surgery is done, it may reveal that the cancer has spread more than the
doctors initially thought. This new information may change the treatment
plan, but it does not change the patient's FIGO stage. This staging system is
different from those for other cancers. The systems for other cancers take
into account whether the cancer has spread to local lymph nodes. The FIGO
doesn't, even though we know the outlook worsens if the cancer has spread to
lymph nodes.
Stage 0: The cancer cells are very superficial (only
affecting the surface) are found only in the layer of cells lining the
cervix, and they have not grown into (invaded) deeper tissues of the cervix.
This stage is also called carcinoma in situ (CIS) or cervical intraepithelial
neoplasis (CIN) grade III.
Stage I: In this stage the cancer has invaded the cervix,
but it has not spread anywhere else.
Stage IA: This is the earliest form of stage I. There is
a very small amount of cancer, and it can be seen only under a microscope.
- Stage IA1: The area of invasion is less than 3 mm
(about 1/8-inch) deep and less than 7 mm (about 1/4-inch) wide.
- Stage IA2: The area of invasion is between 3 mm and 5
mm (about 1/5-inch) deep and less than 7 mm (about 1/4-inch) wide.
Stage IB: This stage includes Stage I cancers that can be
seen without a microscope. This stage also includes cancers that can only be
seen with a microscope if they have spread deeper than 5 mm (about 1/5 inch)
into connective tissue of the cervix or are wider than 7 mm.
- Stage IB1: The cancer can be seen but it is not larger
than 4 cm (about 1 3/5 inches).
- Stage IB2: The cancer can be seen and is larger than 4
cm.
Stage II: In this stage, the cancer has grown beyond the cervix and
uterus, but hasn't spread to the walls of the pelvis or the lower part of the
vagina.
- Stage IIA: The cancer has not spread into the tissues
next to the cervix (called the parametria). The cancer may have grown
into the upper part of the vagina.
- Stage IIB: The cancer has spread into the tissues next
to the cervix.
Stage III: The cancer has spread to the lower part of the
vagina or the pelvic wall. The cancer may be blocking the ureters (tubes that
carry urine from the kidneys to the bladder).
- Stage IIIA: The cancer has spread to the lower third
of the vagina but not to the pelvic wall.
- Stage IIIB: The cancer has grown into the pelvic wall.
If the tumor has blocked the ureters (a condition called hydronephrosis)
it is also a stage IIIB.
Note: In the alternate staging system by the American
Joint Committee on Cancer, stage IIIB is defined by the fact that the cancer
has spread to lymph nodes in the pelvis.
Stage IV: This is the most advanced stage of cervical
cancer. The cancer has spread to nearby organs or other parts of the body.
- Stage IVA: The cancer has spread to the bladder or
rectum, which are organs close to the cervix.
- Stage IVB: The cancer has spread to distant organs
beyond the pelvic area, such as the lungs.
Five-year survival rates by stage
Below are listed the chances a woman will live 5 years after treatment for
the various stages of cervical cancer. These are overall survival figures, so
they also include women who die of other causes. The numbers are approximate
and come from women treated more than 10 years ago.
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Stage
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5-Year
Survival Rate
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IA
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Above 95%
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IB1
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Around 90%
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IB2
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Around 80%-85%
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IIA/B
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Around 75%-78%
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IIIA/B
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Around 47%-50%
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IV
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Around 20%-30%
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Revised: 03/26/2008
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