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Table 4 FIGO 2009 classification for vulvar cancer staging

From: Vulvar cancer staging: guidelines of the European Society of Urogenital Radiology (ESUR)

FIGO stage Description
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
  1. *The depth of invasion is defined as the measurement of the tumour from the epithelial-stromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion