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Staging is the process of finding out how far the cancer has
spread. It is very important because your treatment options and the
outlook for your recovery and survival (prognosis) depend on the stage
of your cancer.
The stage of most vaginal cancers is most often described
using the FIGO (International Federation of Gynecology and Obstetrics)
System of Staging combined with the American Joint Committee on Cancer
TNM system. This system classifies the diseases in Stages 0 through IV
depending on the extent of the tumor (T), whether the cancer has spread
to lymph nodes (N) and whether it has spread to distant sites (M for
metastasis). Vaginal melanoma is not staged using this system. It is
staged like melanoma of the skin. Information about melanoma staging
can be found in our document: Melanoma Skin Cancer.
Tumor extent (T)
Tis: The cancer is not invading into the underlying tissues.
T1: The cancer is only in the vagina.
T2: The cancer has grown through the vaginal wall, but not as far as
the pelvic wall.
T3: The cancer is growing into the pelvic wall.
T4: The cancer is growing into the bladder or rectum or is growing out
of the pelvis.
Lymph node spread of cancer (N)
N0: No lymph node spread
N1: Spread to lymph nodes in the pelvis or groin (inguinal region)
Distant spread of cancer (M)
M0: No distant spread
M1: The cancer has spread to distant sites.
Stage 0 (Tis, N0, M0)
In this stage, cancer cells are only in the top layer of cells
lining the vagina (the epithelium) and have not grown into the deeper
layers of the vagina. Cancers of this stage cannot spread to other
parts of the body. Stage 0 vaginal cancer is also called carcinoma in situ (CIS)
or vaginal intraepithelial neoplasia 3 (VAIN 3).
Stage I (T1, N0, M0)
The cancer has grown through the top layer of cell but it has
not grown out of the vagina and into nearby structures. It has not
spread to nearby lymph nodes or to distant sites.
Stage II (T2, N0, M0)
The cancer has spread to the connective tissues next to the
vagina but has not spread to the wall of the pelvis, to other organs,
or to lymph nodes. (The pelvis is the internal cavity that contains the
internal female reproductive organs, rectum, bladder, and parts of the
large intestine.)
Stage III (T1,2, N1, M0; or T3, any N, M0)
Cancer has spread to the wall of the pelvis (T3) and/or to
lymph nodes nearby (N1). It has not spread to distant sites.
Stage IVA (T4, Any N, M0)
Cancer has spread to organs next to the vagina (such as the
bladder or rectum). It may or may not have spread to lymph nodes. It
has not spread to distant sites.
Stage IVB (Any T, Any N, M1)
Cancer has spread to distant organs such as the lungs.
FIGO stages
FIGO staging is largely based on the size and extent of the
tumor (T):
T1 is FIGO stage I
T2 is FIGO stage II
T3 is FIGO stage III
T4 is FIGO stage IVA
Cancer that has spread to distant sites (M1) is FIGO stage IVB
Survival by stage
The 5-year survival rate refers to the percentage of patients
who live at least 5 years after their cancer is diagnosed. Five-year
rates are used to produce a standard way of discussing prognosis. Of
course, many people live much longer than 5 years. Five-year relative
survival rates assumes that people will die of other causes and
compares the observed survival with that expected for people without
vaginal cancer. That means that relative survival only talks about
deaths from vaginal cancer. The numbers below are based on patients
with vaginal cancer diagnosed from 1988 to 2001.
| AJCC
Stage |
Relative
5-Year Survival Rate |
| I |
68% |
| II |
54% |
| III |
36% |
| IV |
20% |
Keep in mind that 5-year survival rates are based on patients
diagnosed and initially treated more than 5 years ago. Improvements in
treatment may result in a more favorable outlook for women more
recently diagnosed with vaginal cancer.
Last Medical Review: 12/30/2008
Last Revised: 09/14/2009
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