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Staging (Vulva)
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Staging (Vulva)
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CAP Approved Gynecologic • Vulva 4.0.0.1
TNM Descriptors (required only if applicable) (select all that apply)
___ m (multiple primary tumors)
___ r (recurrent)
___ y (posttreatment)
Primary Tumor (pT)
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___ pTX: |
Primary tumor cannot be assessed |
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___ pT0: |
No evidence of primary tumor |
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___ pTis: |
High-grade squamous intraepithelial lesion (carcinoma in situ, VIN 2-3, preinvasive carcinoma) |
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___ pT1a: |
Lesions 2 cm or less in size, confined to the vulva or perineum, and with stromal invasion 1.0 mm or less |
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___ pT1b: |
Lesions more than 2 cm in size or any size with stromal invasion more than 1.0 mm, confined to the vulva or perineum |
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___ pT2: |
Tumor of any size with extension to adjacent perineal structures (lower/distal one-third urethra, lower/distal one third vagina, anal involvement |
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___ pT3: |
Tumor of any size with extension to any of the following: upper/proximal two-thirds of urethra, upper/proximal two-thirds vagina, bladder mucosa, rectal mucosa, or fixed to pelvic bone |
Regional Lymph Nodes (pN) (only inguinal and femoral nodes are considered regional. ITC no greater than 0.2 mm is considered N0(i+).
Category (pN)
___ pNX: Regional lymph nodes cannot be assessed
___ pN0: No regional lymph node metastasis
___ pN1: 1 or 2 regional lymph nodes with the following features
___ pN1a: 1 or 2 lymph node metastasis each less than 5 mm
___ pN1b: 1 lymph node metastasis 5 mm or greater
___ pN2: Regional lymph node metastasis with the following features
___ pN2a: 3 or more lymph node metastases each less than 5 mm
___ pN2b: 2 or more lymph node metastases 5 mm or greater
___ pN2c: Lymph node metastasis with extracapsular extension
___ pN3: Fixed or ulcerated regional lymph node metastasis
Distant Metastasis (pM) (required only if confirmed pathologically in this case)
___ pM1: Distant metastasis (including pelvic lymph node metastasis; internal iliac,/hypogastric, external iliac, and common iliac LN are considered distant metastases)
Specify site(s), if known: ____________________________
Vulva CAP 4.0.0.1 summary of pTNM changes AJCC 7th to 8th edition
- pN1a changed from “1 or 2 lymph node metastasis each 5 mm or less” to “1 or 2 lymph node metastasis each less than 5 mm”