TABLE 241-5. STAGING OF VULVAR CARCINOMA

TABLE 241-5. STAGING OF VULVAR CARCINOMA^a
Stage	TNM Classification	Description
0	Tis	Carcinoma in situ, intraepithelial carcinoma
I^b	T1N0M0	Lesions ≤ 2 cm in size confined to the vulva or perineum; no nodal metastasis
Ia		Lesions ≤ 2 cm in size confined to the vulva or perineum with stromal invasion ≤ 1 mm^c; no nodal metastasis
Ib		Lesions ≤ 2 cm in size confined to the vulva or perineum with stromal invasion > 1 mm; no nodal metastasis
II	T2N0M0	Tumor > 2 cm in largest dimension confined to the vulva or perineum; no nodal metastasis
III	T3N0M0 T3N1M0 T1N1M0 T2N1M0	Tumor of any size with adjacent spread to the lower urethra, the vagina, or the anus or with unilateral regional lymph node metastasis
IVa	T1N2M0 T2N2M0 T3N2M0 T4 Any N M0	Tumor invading any of the following: upper urethra, bladder mucosa, rectal mucosa, pelvic bone, or bilateral regional nodes
IVb	Any T Any T M1	Any distant metastasis, including pelvic lymph nodes
^aAs described by the International Federation of Gynecology and Obstetrics (FIGO).
^bChanged in 1995 (Creasman WT: "New gynecologic cancer staging." Gynecologic Oncology 58:157, 1995).
^cThe depth of invasion is the measurement of the tumor from the epithelial-stromal junction of the adjacent-most superficial dermal papilla to the deepest point of invasion.
Tis 4 in situ tumor; T = tumor (indicating size or involvement); N = node (indicating regional lymph node involvement); M = metastasis (indicating extent).