Table 4 FIGO 2009 classification for vulvar cancer staging

I

Tumour confined to the vulva (without nodal metastasis)

 IA

 Lesions ≤ 2 cm in size with stromal invasion* ≤ 1 mm

 IB

 Lesions > 2 cm in size with stromal invasion* > 1 mm

II

Tumour of any size with extension to the adjacent perineal structures (lower third of urethra, lower third of vagina, anus) without nodal metastasis

III

Tumour of any size, with or without extension to adjacent perineal structures (lower third of urethra, lower third of vagina, anus) with positive inguinofemoral nodes

 IIIA

 1. With 1 lymph node metastasis (≥ 5 mm), or

 2. With 1–2 lymph node metastases (< 5 mm)

 IIIB

 1. With 2 or more lymph node metastases (≥ 5 mm), or

 2. With 3 or more lymph node metastases (< 5 mm)

 IIIC

 With positive nodes with extracapsular spread

IV

Tumour invades any of the following:

 IVA

 1. Upper urethral and/or vaginal mucosa, bladder mucosa, rectal mucosa, or is fixed to pelvic bone

 2. Fixed or ulcerated inguinofemoral lymph nodes

 IVB

 Any distant metastasis including pelvic lymph nodes