TNM Category/FIGO Stage

Primary tumor (T)

• TX: Primary tumor cannot be assessed
• T0: No evidence of primary tumor
• Tis/0: Carcinoma in situ (preinvasive carcinoma)
• T1/I: Tumor confined to the vulva or vulva and perineum, 2 cm or less in greatest dimension
  • T1a/IA: Tumor confined to the vulva or vulva and perineum, 2 cm or less in greatest dimension, and with stromal invasion no greater than 1 mm.
  • T1b/IB: Tumor confined to the vulva or vulva and perineum, 2 cm or less in greatest dimension, and with stromal invasion greater than 1 mm.
• T2/II: Tumor confined to the vulva or vulva and perineum, more than 2 cm in greatest dimension
• T3/III: Tumor of any size with contiguous spread to the lower urethra and/or vagina or anus
• T4/IVA: Tumor invades any of the following: upper urethra, bladder mucosa, rectal mucosa, or is fixed to the pubic bone

   [Note: The depth of invasion is defined as the measurement of the tumor from the epithelial-stromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion.]

Regional lymph nodes (N)

• NX: Regional lymph nodes cannot be assessed
• N0: No regional lymph node metastasis
• N1/III: Unilateral regional lymph node metastasis
• N2/IVA: Bilateral regional lymph node metastasis

Every effort should be made to determine the site and laterality of lymph node metastases. However, if “regional lymph node metastases, NOS” is the final diagnosis, then the patient should be staged as N1.

Distant metastasis (M)

• MX: Distant metastasis cannot be assessed
• M0: No distant metastasis
• M1/IVB: Distant metastasis (including pelvic lymph node metastasis)

Stage 0

• Tis, N0, M0

Stage I

• T1, N0, M0

Stage IA

• T1a, N0, M0

Stage IB

• T1b, N0, M0

Stage II

• T2, N0, M0

Stage III

• T1, N1, M0
• T2, N1, M0
• T3, N0, M0
• T3, N1, M0

Stage IVA

• T1, N2, M0
• T2, N2, M0
• T3, N2, M0
• T4, any N, M0

Stage IVB

• Any T, any N, M1