The FIGO/AJCC system for staging vulvar cancer

The stage of most types of vulvar cancer 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. This system is not used to stage vulvar melanoma. 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 growing into the underlying tissues.

T1: The cancer is growing only in the vulva or perineum and is smaller than 2 cm. (about 0.8 inches).

T1a: The cancer has grown no more than 1 mm into underlying tissue.

T1b: The cancer has grown more than 1 mm into underlying tissue.

T2: The cancer is growing only in the vulva or perineum and is larger than 2 cm. (about 0.8 inches).

T3: The cancer is growing into the anus, vagina, or lower urethra (the tube that drains urine from the bladder).

T4: The cancer is growing into the upper urethra, bladder or rectum or into the pubic bone.

Lymph node spread of cancer (N)

N0: No lymph node spread

N1: cancer has spread to lymph nodes on the same side as the tumor

N2: cancer has spread to lymph nodes in both groin regions

Distant spread of cancer (M)

M0: No distant spread

M1: The cancer has spread to distant sites (includes spread to pelvic lymph nodes)

Stage grouping

The grouping of T, N, and M determines the stage:

Stage 0 (Tis, N0, M0):

This is a very early cancer found in the surface of the skin of the vulva only. It is also known as carcinoma in situ. and as Bowen disease.

Stage I (T1, N0, M0):

The cancer is in the vulva or the perineum (the space between the rectum and the vagina) or both. The tumor is 2 cm or less (about 3/4 inch) in diameter and has not spread to lymph nodes or distant sites.

Stage IA: T1a: These are stage I cancers with invasion no deeper than 1 mm (about 1/25 inch).

Stage IB: T1b: These are stage I cancers that have invaded deeper than 1 mm.

Stage II (T2, N0, M0):

The cancer is in the vulva or perineum or both, and the tumor is larger than 2 cm. It has not spread to lymph nodes or distant sites.

Stage III (T3, N0-N1, M0, or T1-T2, N1, M0):

The cancer is growing into the anus, vagina, or lower urethra. It may have spread to nearby lymph nodes on 1 side of the groin. It has not spread to distant sites (T3, N0-N1, M0).

OR

Cancer is found in the vulva or perineum or both and has spread to nearby lymph nodes on 1 side of the groin. It has not spread to distant sites. (T1-T2, N1, M0)

Stage IVA (T1-3, N2, M0, or T4, any N, M0):

Cancer has spread to lymph nodes on both sides of the groin (N2) or it has spread beyond nearby tissues to the upper part of the urethra, bladder, rectum, or pelvic bone (T4). It has not spread to distant sites.

Stage IVB (any T, any N, M0):

Cancer has spread to distant organs or lymph nodes. This is the most advanced stage of cancer.

Recurrent: The cancer has come back after treatment.

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 survival 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 assume that people will die of other causes and compare the observed survival with that expected for people without vulvar cancer. That means that relative survival only talks about deaths from vulvar cancer. Similarly, 10-year survival rates refer to the percentage of patients who live at least 10 years after diagnosis.

Keep in mind that 5-year survival rates are based on patients diagnosed and initially treated more than 5 years ago. Improvements in treatment often result in a more favorable outlook for women more recently diagnosed with vulvar cancer

The numbers below come from the National Cancer Institute. They are based on patients diagnosed from 1998 to 2001.

Survival rates for squamous cell carcinoma of the vulva, by stage

Survival rates for adenocarcinoma of the vulva, by stage

Survival rates for vulvar melanoma, by stage

Last Medical Review: 12/30/2008
Last Revised: 05/14/2009