Vaginal cancer

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Staging vaginal cancer

Staging is a way of describing or classifying a cancer based on the extent of cancer in the body. Extent includes the amount of cancer in the tissues in or near the vagina and where the cancer is in the body. Your healthcare team uses the stage to plan treatment and estimate your prognosis.

The most common staging system for vaginal cancer is the FIGO system. Each stage is given a number from 1 to 4. Stages 1 to 4 are usually given as the Roman numerals I, II, III and IV. Generally, the higher the number, the more the cancer has spread.

When describing the stage, doctors may use the terms local, regional or distant. Local means that the cancer is only in the vagina and has not spread to other parts of the body. Regional means close to or around the vagina. Distant means in a part of the body farther from the vagina.

The FIGO classification system applies only to primary vaginal carcinomas (squamous cell carcinoma and adenocarcinoma). Melanoma and sarcoma of the vagina are not staged using the FIGO system. Melanoma of the vagina is staged as a melanoma of the skin. Sarcoma of the vagina is staged as soft tissue sarcoma.

TNM descriptions

T describes the primary tumour and if it has grown into tissues around the vagina. T is usually given as a number from 1 to 4. A higher number means that the tumour has grown deeper into nearby tissues.

N describes the lymph nodes in the pelvis, called pelvic lymph nodes. N0 means the cancer hasn’t spread to the lymph nodes. N1 means cancer has spread to lymph nodes.

M describes whether or not the cancer has spread, or metastasized, to other parts of the body. M0 means that cancer has not spread to other parts of the body. M1 means that it has spread to other parts of the body.

Stage grouping for vaginal cancer

FIGO groups the TNM data into the stages listed in the tables below.

Stage 0 (Tis N0 M0) is not included in the FIGO system. Stage 0 is also called vaginal intraepithelial neoplasia III (VAIN III) or carcinoma in situ. In VAIN III the cancer cells are only in the epithelium (surface layer of cells lining the vagina) and have not spread into the deeper layers of the vagina.

Stage I
StageTNMDescription

I

T1

N0

M0

The cancer is only found on the wall of the vagina.

 

Stage II
StageTNMDescription

II

T2

N0

M0

The cancer has spread to tissues next to the vagina but not onto the wall of the pelvis or to other nearby organs.

Stage III
StageTNMDescription

III

T3

any N

M0

The cancer has spread onto the wall of the pelvis. There may be spread to the lymph nodes.

T1–3

N1

M0

The cancer is in the vagina. It may have spread into the tissues next to the vagina or to the wall of the pelvis. There is spread to nearby lymph nodes.

Stage IV
StageTNMDescription

IVA

T4

any N

M0

The cancer has grown out of the vagina and spread to the lining of the bladder or rectum, beyond the pelvis or both.

The cancer may or may not have spread to lymph nodes.

IVB

any T

any N

M1

The tumour may or may not have grown into any surrounding tissues.

The cancer may or may not have spread to lymph nodes.

The cancer has spread to other parts of the body that are not near the vagina, such as the lungs (called distant metastasis).

Recurrent vaginal cancer

Recurrent vaginal cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where the cancer first started, it’s called regional recurrence. It can also recur in another part of the body, which is called a distant metastasis, or a distant recurrence.

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