Tumour confined to the vulva
- IA Lesions <2 cm in size, confined to the vulva or perineum and with stromal invasions <1.0 mm*, no nodal metastasis
- IB Lesions >2 cm in size or with stromal invasion >1.0 mm* confined to the vulva or perineum, with negative nodes
Tumour of any size with extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with negative nodes
Tumour of any size with or without extension to adjacent perineal structures (1/3 lower urethra, 1/3 lower vagina, anus) with positive inguino-femoral lymph nodes.
- IIIA (i) With 1 lymph node metastasis (>5 mm), or (ii) 1-2 lymph node metastasis(es) (<5 mm)
- IIIB (i) With 2 or more lymph node metastases (>5 mm), or (ii) 3 or more lymph node metastases (<5 mm)
- IIIC With positive nodes with extracapsular spread
Tumour invades other regional (2/3 upper urethra, 2/3 upper vagina), or distant structures.
- IVA Tumour invades any of the following:
- (i) upper urethral and/or vaginal mucosa, bladder mucosa, rectal mucosa, or fixed to pelvic bone, or (ii) fixed or ulcerated inguino-femoral lymph nodes
- IVB Any distant metastasis including pelvic lymph nodes
* The depth of invasion is defined as the measurement of the tumour from the epithelial-stromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion.