Gynae Staging

Question 1

CERVIX Stage IA

Answer 1

Microscopy only. Limited to cervix uteri.

IA1 stromal invasion <3mm in depth

IA2 stromal invasion ≥3mm and <5mm in depth

Question 2

CERVIX Stage IB

Answer 2

Limited to cervix uteri.

IB1 ≥5mm stromal invasion and <2cm in greatest dimension

IB2 ≥2cm and <4cm in greatest dimension

IB3 ≥4cm in greatest dimension

Question 3

CERVIX Stage II A

Answer 3

Limited to upper 2/3 of vagina without parametrial involvement. No extension to lower third of vagina or pelvic wall.

IIA1 <4cm in greatest dimension

IIA2 ≥4cm in greatest dimension

Question 4

CERVIX Stage II B

Answer 4

No extension to lower third of vagina or pelvic wall.

Parametrial involvement

Question 5

CERVIX Stage III A

Answer 5

Involves lower third of the vagina with no extension to the pelvic wall

Question 6

CERVIX Stage III B

Answer 6

Extension to pelvic wall and/or hydronephrosis or non-functioning kidney (unless another cause)

Question 7

CERVIX Stage III C

Answer 7

Involvement of pelvic and/or para-aortic lymph nodes

IIIC1 pelvic LN mets only

IIIC2 para-aortic lymph node mets

Question 8

CERVIX Stage IV

Answer 8

Extended beyond true pelvis, or involves (bx proven) mucosa of bladder or rectum

IV A = adjacent pelvic organs

IV B = spread to distant organs

Question 9

Endometrium Stage I

Answer 9

Confined to uterus

IA < 1/2 myometrium involvement

IB ≥1/2 myometrium involvement

Question 10

Endometrium Stage II

Answer 10

Tumour invades cervical stroma but does not extend beyond uterus (endocervix consider Stage I not Stage II)

Question 11

Endometrium Stage III

Answer 11

IIIA Invades serosa of corpus uteri and/or adnexae

IIIB Vaginal and/or parametrial involvement

IIIC Mets to pelvic and/or para-aortic lymph nodes
IIIC1 positive pelvic nodes
IIIC2 positive para-aortic lymph nodes with or without positive pelvic lymph nodes

Question 12

Endometrial Stage IV

Answer 12

IVA Invades bladder and/or bowel mucosa

IVB Distant mets including intra-abdominal and/or inguinal lymph nodes

Question 13

Ovarian Stage IA

Answer 13

Limited to 1 ovary, capsule intact, no tumour on surface, negative washings

Question 14

Ovarian Stage IB

Answer 14

Involves both ovaries, capsule intact, no tumour on surface, negative washings

Question 15

Ovarian Stage IC

Answer 15

Limited to one or both ovaries

ICI surgical spill

IC2 capsule rupture before surgery or tumour on ovarian surface

IC3 malignant cells in ascites or peritoneal washing

Question 16

Ovarian Stage II A

Answer 16

Involves 1 or both ovaries with pelvic extension below pelvic brim or primary peritoneal ca.

Extension and/or implant on uterus and/or fallopian tubes

Question 17

Ovarian Stage II B

Answer 17

Involves 1 or both ovaries with pelvic extension below pelvic brim or primary peritoneal ca.

Extension to other pelvic intraperitoneal tissues

Question 18

Ovarian Stage III A

Answer 18

III A1 Positive retroperitoneal LN only
i) mets ≤ 10mm
II) mets > 10mm

III A2 Microscopic extrapelvic (above the brim) peritoneal involvement +/- retroperitoneal lymph nodes

Question 19

Ovarian Stage III B

Answer 19

Macroscopic, extra pelvic, peritoneal metastasis ≤2cm +/- positive retroperitoneal nodes. Includes extension to capsule of liver/ spleen

Question 20

Ovarian Stage III C

Answer 20

Macroscopic, extra pelvic, peritoneal metastasis >2cm +/- positive retroperitoneal lymph nodes. Includes extension to capsule of liver/ spleen

Question 21

Ovarian Stage IV A

Answer 21

Pleural Effusion with positive cytology

Question 22

Ovarian Stage IV B

Answer 22

Hepatic and/or splenic parenchymal mets

Mets to extra-abdominal organs, including inguinal lymph nodes and lymph nodes outside of the abdominal cavity.

Question 23

Vagina Stage I

Answer 23

Limited to wall of vagina

Question 24

Vagina Stage II

Answer 24

Involved sub-vaginal tissue, but not extended to pelvic wall

Question 25

Vagina Stage III

Answer 25

Carcinoma has extended to pelvic wall

Question 26

Vagina Stage IV A

Answer 26

Invades bladder and/or rectal mucosa and/ or direct extension beyond the true pelvis (bullous oedema does not count)

Question 27

Vagina Stage IV B

Answer 27

Spread to distant organs

Question 28

Vulva Stage IA

Answer 28

Confined to vulva or perineum Lesions ≤ 2cm, Stromal invasion ≤1mm

Question 29

Vulva Stage IB

Answer 29

Confined to vulva or perineum Lesions > 2cm Stromal invaion >1mm

Question 30

Vulva Stage II

Answer 30

Any size Extension to perineal structures 1/3 lower urethra 1/3 lower vagina, anus

Question 31

Vulva Stage III A

Answer 31

i) 1 LN met ≥ 5mm | ii) 1-2 LN met < 5mm

Question 32

Vulva Stage III B

Answer 32

i) 2 or more LN mets ≥5mm | ii) 3 or more LN mets <5mm

Question 33

Vulva Stage III C

Answer 33

Positive nodes with ECS

Question 34

Vulva Stage IV A

Answer 34

i) Invades 2/3 upper urethra and/ or 2/3 upper vagina Bladder mucosa Rectal mucosa Fixed to pelvic bone or ii) fixed or ulcerated inguino-femoral lymph nodes

Question 35

Vulva Stage IV B

Answer 35

Any distant mets including pelvic lymph nodes