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In Recent Clinical News

Scanning Medical Journals

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Vulvar Cancer Staging

FIGO Vulvar Staging (2021)

Updated Nodes Classification

I

Confined to Vulva/Perineum

IA (≤2cm, ≤1mm invasion) | IB (>2cm or >1mm invasion)

II

Adjacent Tissue Extension

Lower 1/3 Urethra, Vagina, or Anus (Nodes Negative)

III

Positive Regional Nodes

IIIA (1 node ≥5mm or 1–2 nodes <5mm) | IIIB (2+ nodes ≥5mm) | IIIC (Extracapsular spread)

IV

Upper Tract / Distant

IVA (Upper 2/3 Urethra/Vagina, Bladder/Rectum mucosa) | IVB (Distant Metastasis)

The 2021 update refined the Prognostic Node groups (Stage III) based on absolute node size and extracapsular spread.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Primary Clinical Uses

Surgical/pathological staging of primary vulvar squamus cell carcinoma and melanomas
Major determinant for the extent of inguinofemoral lymph node dissection
Guiding the necessity for adjuvant groin/pelvic radiotherapy

The 2021 Update

The 2021 FIGO update made critical modifications regarding lymph node morphology. Extracapsular spread (ECS) in the groin nodes is now officially recognized as overwhelmingly prognostic and immediately upstages the patient to IIIC.

Last Comprehensive Review: 2026