Stage Information for Vaginal Cancer

        TNM Definitions
AJCC Stage Groupings

Note: The American Joint Committee on Cancer has recently published a new edition of the AJCC Cancer Staging Manual, which includes revisions to the staging for this disease. The PDQ Adult Treatment Editorial Board, which is responsible for maintaining this summary, is currently reviewing the new staging to determine the changes that need to be made in the summary. In addition to updating this Stage Information section, additional changes may need to be made to other parts of this summary to ensure that it is up-to-date. The changes will be made as soon as possible.

Cervical biopsies are mandatory to rule out carcinoma of the cervix. Carcinoma of the vulva should also be ruled out.

Stages are defined by the Federation Internationale de Gynecologie et d’Obstetrique (FIGO) and the American Joint Committee on Cancer’s (AJCC) TNM classification.[1] The definitions of the T categories correspond to the stages accepted by the FIGO, and both systems are included for comparison.

TNM Categories/FIGO Stages

Primary tumor (T)

• TX: Primary tumor cannot be assessed
• T0: No evidence of primary tumor
• Tis/ 0: Carcinoma in situ
• T1/I: Tumor confined to vagina
• T2/II: Tumor invades paravaginal tissues but not to pelvic wall*
• T3/III: Tumor extends to pelvic wall*
• T4/IVA: Tumor invades mucosa of the bladder or rectum and/or extends beyond the true pelvis (Bullous edema is not sufficient evidence to classify a tumor as T4.)

* [Note: Pelvic wall is defined as muscle, facia, neurovascular structures, or skeletal portions of the bony pelvis.]

Regional lymph nodes (N)

• NX: Regional nodes cannot be assessed
• N0: No regional lymph node metastasis
• N1/IVB: Pelvic or inguinal lymph node metastasis

Distant metastasis (M)

• MX: Distant metastasis cannot be assessed
• M0: No distant metastasis
• M1/IVB: Distant metastasis

Stage 0

• Tis, N0, M0

Stage I

• T1, N0, M0

Stage II

• T2, N0, M0

Stage III

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

Stage IVA

• T4, any N, M0

Stage IVB

• Any T, any N, M1

References

1. Vagina. In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002, pp 251-257.