Vulvar Cancer: Stages

Approved by the Cancer.Net Editorial Board, 12/2016

ON THIS PAGE: You will learn how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other organs in the body. For vulvar cancer, the stage is determined by performing surgery and evaluating the removed tissues, the vulva, the underlying and nearby tissues, and the lymph nodes in the groin.

Knowing the stage helps the doctor to decide if additional treatment may be necessary and can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

Vulvar cancer stage

Vulvar cancer is staged using the FIGO (International Federation of Obstetrics and Gynecology) staging system.

Stage I: The tumor is only in the vulva or the vulva and perineum, and it has not spread.

  • IA: The tumor is only in the vulva or the vulva and perineum, is 2 cm or smaller, has not spread, and is no deeper than 1 mm.
  • IB: The tumor is larger than 2 cm or is deeper than 1 mm, but is only in the vulva or the vulva and perineum.

Stage II: The tumor is of any size and has spread to nearby structures, including the lower part of the urethra, vagina, or anus. It has not spread to lymph nodes or other parts of the body.

Stage III: The cancer has spread to nearby tissue, such as the vagina, anus, or urethra, and to the groin lymph nodes. There are no distant metastases.

  • IIIA: The cancer has spread to nearby tissue (the vagina, anus, or urethra). There are 1 or 2 metastases to lymph nodes, but they are smaller than 5 mm, or there is 1 metastasis that is 5 mm. There are no distant metastases.
  • IIIB: The cancer has spread to nearby tissue (the vagina, anus, or urethra). There are 3 or more metastases to lymph nodes, but they are smaller than 5 mm, or there are 2 or more metastases that are 5 mm. There are no distant metastases.
  • IIIC: The cancer has spread to nearby tissue (the vagina, anus, or urethra) and to 1 or more lymph nodes and their surrounding lymph node capsule, or covering. There are no distant metastases.

Stage IV: The cancer has spread to the upper part of the vagina or upper part of the urethra, or it has spread to a distant part of the body.  

  • IVA: The tumor has spread to the upper part of the urethra, vagina, or anus; the cancer has spread to regional lymph nodes and caused ulceration; or it has attached the lymph node to the tissue beneath it. There are no distant metastases.
  • IVB: Cancer has spread to a distant part of the body.

Sources for FIGO staging system:

  1. FIGO Committee on Gynecologic Oncology. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynecol Obstet 2009;105:103–104.
  1. Hacker NF. Revised FIGO staging for carcinoma of the vulva. Int J Gynecol Obstet 2009;105:105–106.

Recurrent cancer

Recurrent cancer is cancer that has come back after treatment. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. Vulvar cancers that recur only on the vulva can often be treated effectively. These tests and scans are often similar to those done at the time of the original diagnosis.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. You may use the menu to choose a different section to continue reading in this guide.