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Cervical Cancer Staging

FIGO Cervical Cancer Staging (2018 Revision)

Bhatla et al. Int J Gynaecol Obstet 2019; Indian J Med Res 2021

Lymph Node (IIIC) Notation Requirement

Any lymph node metastasis automatically assigns stage IIIC. Use “r” if based on imaging (e.g., IIIC1r, IIIC2r) and “p” if based on pathological examination (e.g., IIIC1p, IIIC2p). Pathological findings supersede imaging when both are available. Micrometastases (0.2–2 mm) qualify as IIIC; isolated tumor cells (≤0.2 mm) do not change stage but must be recorded.

Sources: Medscape (2026); Bhatla N, et al. Int J Gynaecol Obstet. 2019;145:129-135; Bhatla N, et al. Indian J Med Res. 2021;154(2):273-283.

Imaging (MRI/CT/PET) and pathology findings are permitted to modify stage assignment per 2018 FIGO revision.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Primary Clinical Uses

Universal staging system for carcinoma of the cervix uteri to guide treatment and predict prognosis

Determines eligibility for fertility‑sparing surgery, radical hysterectomy, primary chemoradiation, or systemic therapy

Mandatory for clinical trial enrollment and international research comparisons

2018 Paradigm Shift (Bhatla et al., 2021)

Prior to 2018, staging was strictly clinical (palpation, basic imaging). The revision integrates cross‑sectional imaging (MRI, CT, PET) and surgical pathology findings, recognizing that clinical examination understages tumor size and lymph node involvement in 20‑30% of cases.

Last Comprehensive Review: 2026

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