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Mnemonics, Simplified Concepts & Thoughts

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Mnemonics, Simplified Concepts & Thoughts

Staging of Gynecological Cancers : Simplified

Epomedicine, Apr 5, 2026

FIGO-staging is a classification system used to describe size and extent of gynaecological cancers, using the FIGO nomenclature (International Federation of Gynecology and Obstetrics).

  • 0: Carcinoma in situ (CIS)
  • I: Growth limited to organ of origin
  • II: Invasion of surrounding organs and tissues
  • III: Spread to nodes or tissues within pelvis
  • IV: Distant metastasis
gynecological cancers
Carcinoma cervixEndometrial cancerCarcinoma ovary
Basis of stagingClinical (examination + radiographs)Surgical (pathologic assessment)Surgical (pathologic assessment)
FIGO stages201820232014
IConfined to cervix
– A: Microscopic
– B: Macroscopic
Confined to uterine corpus
– A: <1/2 Myometrium
– B: >1/2 Myometrium
Limited to ovaries
– A: 1 ovary
– B: 2 ovaries
– C: Surgical spill/Surface growth/Malignant ascites
IIBeyond uterus:
A – upper 2/3 vagina
B – parametrium
Cervical stromaPelvic extension
IIILower 1/3 vagina &/or Pelvic wall &/or Renal involvement &/or Pelvic/para-aortic lymph nodesUterine serosa, Adnexa, Vagina or Lymph nodesAbdominal extension including retroperitoneal lymph nodes and superficial liver/spleen
IVA – Spread to adjacent organs
B – Spread to distant organs (inguinal lymph nodes not involved)
A – Spread to adjacent organs
B – Spread to distant organs including inguinal lymph nodes
Distant metastasis
A – Malignant pleural effusion
B – Deep liver/spleen deposits or inguinal lymph nodes
Treatment
I-IIA: Radical hysterectomyI: TAH + BSOI: TAH + BSO
IIB-IV: Chemo-radiotherapyII-IV: Extended or modified radical hysterectomy + BSO + LN dissectionII-IV: Partial removal of tumor followed by platinum chemotherapy
High grade or Surgery contraindicated: Chemo-radiotherapyRecurrent cases: Other chemotherapy and Radiotherapy
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PGMEE, MRCS, USMLE, MBBS, MD/MS ObGynOncology

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