Σταδιοποίηση σε Ca Κόλπου

 

Ca Κόλπου

AJCC Stages

Stage

T

N

M

0

Tis

N0

M0

I

T1

N0

M0

II

T2

N0

M0

III

T1-T3

N1

M0

T3

N0

M0

IVA

T4

Any N

M0

IVB

Any T

Any N

M1

(T) Primary Tumor

TNM

FIGO

Definitions

TX

 

Primary tumor cannot be assessed

T0

 

No evidence of primary tumor

Tis¹

 

Carcinoma in situ (preinvasive carcinoma)

T1

I

Tumor confined to vagina

T2

II

Tumor invades paravaginal tissues but not to pelvic wall

T3

III

Tumor extends to pelvic wall²

T4

IVA

Tumor invades mucosa of the bladder or rectum &/or extends beyond true pelvis (bullous edema is not sufficient evidence to classify a tumor as T4)

¹FIGO no longer includes stage 0 (Tis). 
²Pelvic wall is defined as muscle, fascia, neurovascular structures, or skeletal portions of the bony pelvis. On rectal examination, there is no cancer-free space between the tumor and pelvic wall.

(N) Regional Lymph Nodes

NX

 

Regional lymph nodes cannot be assessed

N0

 

No regional lymph node metastasis

N1

III

Pelvic or inguinal lymph node metastasis

(M) Distant Metastasis

M0

 

No distant metastasis

M1

IVB

Distant metastasis

Χαρακτηριστικά Επέκτασης

Local spread

  • Tumor spreads locally into paravaginal soft tissues and eventually to pelvic side wall, mucosa of bladder, or rectum

Lymphatic spread

  • Early spread to regional lymph nodes
    • 1/3 of patients have pelvic or groin lymph node involvement at diagnosis
  • Nodal spread usually depends on site of primary tumor
  • Expected nodal disease
    • Upper and middle 1/3 → pelvic obturator nodes, internal and external iliac nodes, and paraaortic nodes
    • Lower 1/3 → inguinal and femoral nodes
    • Disease progression or tumor involving whole length of vagina may → inguinal and iliac nodes
  • Lymphatic drainage does not always follow expected lymphatic channels predicted anatomically based on tumor location

Hematogenous spread

  • Most common sites of distant metastases are lung, liver, and bone

Κατηγοριοποίηση (Ιστολογικοί Τύποι)
  • Squamous cell carcinoma
    • Approximately 85-90% of cases
  • Adenocarcinoma
    • Approximately 10% of cases
  • Adenosquamous carcinoma
    • Approximately 1-2% of cases
  • Melanoma
  • Sarcoma