Comparison between revised 2021 International Federation of Gynecology and Obstetrics (FIGO) and 2017 8th version of TNM staging vulvar cancer
| Stage | Year | TNM | FIGO | FIGO (continued) | FIGO (continued) |
| Stage I | 2009 | I T1 N0M0 | IA T1a N0M0 | IB T1bN0M0 | |
| Tumor confined to the vulva | IA: Tumor size ≤2 cm and stromal invasion ≤1 mm | IB: Tumor size >2 cm or stromal invasion >1 mm | |||
| Stage I | 2021 | Tumor confined to the vulva | IA: Tumor size ≤2 cm and stromal invasion ≤1 mm* | IB: Tumor size >2 cm or stromal invasion >1 mm* | |
| Stage II | 2009 | II T2 N0 M0 | |||
| Tumor of any size with extension to the lower one-third of the urethra, lower one-third of vagina, anus with negative nodes | |||||
| Stage II | 2021 | Tumor of any size with extension to the lower one-third of the urethra, lower one-third of vagina, anus with negative nodes | |||
| Stage III | 2009 | III T1-T2 N1-N2c M0 | IIIA T1-T2 N1 M0 | IIIB T1-2 N2a, N2b M0 | IIIC T1-2 N2c M0 |
| Tumor of any size, with/without extension to adjacent perineal structures (lower third of urethra, the lower third of vagina, anus) with positive inguinofemoral lymph nodes | With one lymph node metastasis (≥5 mm) or 1–2 lymph node metastases (<5 mm) | With two or more lymph node metastases (≥5 mm) or three or more lymph node metastases (<5 mm) | With positive lymph nodes with extracapsular spread | ||
| Stage III | 2021 | III T3 (non-fixed to the bone) or N+ (non-ulcerated/non-fixed) M0 | IIIA T1-T2 N+ (≤5 mm and no extracapsular spread) M0 T3 N0/N+ (≤5 mm and no extracapsular spread) M0 | IIIB T1-3 N+ (>5 mm and no extracapsular spread) M0 | IIIC T1-3 N+ (extracapsular spread) M0 |
| Tumor of any size with extension to upper part of adjacent perineal structures, or with any number of non-fixed, non-ulcerated lymph nodes | Tumor of any size with disease extension to upper two-thirds of the urethra, upper two-thirds of the vagina, bladder mucosa, rectal mucosa, or regional† lymph node metastases ≤5 mm | Regional† lymph node metastases >5 mm | Regional† lymph node metastases with extracapsular spread | ||
| Stage IV | 2009 | IV T1-T3 N3 M0-M1 | IVA T1-T2 N3 M0 T3 any N M0 | IVB Any T any N M1 | |
| Tumor invades adjacent structures or fixed and ulcerated lymph nodes or distant metastases | Upper urethral and/or vaginal mucosa, bladder mucosa, rectal mucosa, or is fixed to the pelvic bone. Fixed or ulcerated inguinofemoral lymph nodes | Any distant metastases, Including pelvic lymph nodes | |||
| Stage IV | 2021 | IV T3 (fixed to the bone) or N+ (ulcerated/fixed) or M1 | IVA Any T N+ (fixed/ulcerated) M0 T3 (fixed to the bone) any N M0 | IVB Any T any N M1 | |
| Tumor of any size fixed to the bone, or fixed and ulcerated lymph node metastases, or distant metastases | Disease fixed to the pelvic bone,or fixed or ulcerated regional† lymph node metastases | Distant metastases |
*Stromal invasion measured by new method; from the basement membrane of the deepest adjacent dysplatic (tumor-free) rete ridge to the deepest point of invasion.
†Inguinal and femoral lymph nodes.
M, metastasis; N, node; T, tumor.