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.
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What is cancer staging?
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, which are the small, bean-shaped organs that help fight infection. Imaging scans (see Diagnosis) are also used as part of staging. Knowing the stage helps the doctor recommend additional treatment should it 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. For vulvar cancer, the staging system developed by the International Federation of Obstetrics and Gynecology (Federation Internationale de Gynecologie et d'Obstetrique, or FIGO), is most commonly used.
FIGO stages for vulvar cancer
Doctors assign the stage of the cancer by evaluating the tumor and whether the cancer has spread to lymph nodes and other parts of the body.
Tumor size is measured in centimeters (cm). There are 10 millimeters (mm) in 1 cm.
Stage I: The tumor is only in the vulva. It has not spread.
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IA: The tumor is only in the vulva, is 2 cm or smaller, and is no deeper than 1 mm.
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IB: The tumor is larger than 2 cm or is deeper than 1 mm, but it is only in the vulva.
Stage II: The tumor is of any size and has spread to the lower one-third of 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 tumor is of any size and has spread to the upper part of nearby structures, such as the vagina, anus, or urethra, or to the groin lymph nodes. There are no distant metastases.
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IIIA: The cancer has spread to the upper two-thirds of nearby structures (the vagina, anus, urethra, or bladder mucosa) or to the regional lymph nodes, where the metastases are 5 mm or smaller. There are no distant metastases.
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IIIB: The cancer has spread to the regional lymph nodes, and the metastases are larger than 5 mm. There are no distant metastases.
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IIIC: The cancer has spread to the regional lymph nodes, where it is spreading outside of the lymph node capsule.
Stage IV: The cancer has fixed to the bone, has fixed to or caused ulceration of the lymph nodes, or has spread to a distant part of the body.
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IVA: The tumor has spread to the pelvic bone; the cancer has spread to regional lymph nodes and caused ulceration; or the cancer has attached the lymph node to the tissue beneath it. There are no distant metastases.
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IVB: The cancer has spread to a distant part of the body.
Source for FIGO staging system:
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Olawaiye, A., Cotler, J., Cuello, M., Bhatla, N., Okamoto, A., Wilailak, S., Purandare, C. N., Lindeque, G., Berek, J. S., & Kehoe, S. (2021). FIGO staging for carcinoma of the vulva: 2021 revision. International Journal of Gynecology & Obstetrics, 155(1), 43–47. https://doi.org/10.1002/ijgo.13880
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. These tests and scans are often similar to those done at the time of the original diagnosis. Vulvar cancers that recur only on the vulva can often be treated effectively.
Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.