Stages of vaginal cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

The most common staging system for vaginal cancer is the FIGO system. For vaginal cancer there are 4 stages. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.

The FIGO staging system applies only to primary vaginal carcinomas (squamous cell carcinoma and adenocarcinoma). Melanoma and sarcoma of the vagina are not staged using the FIGO system. Melanoma of the vagina is staged as a melanoma of the skin. Sarcoma of the vagina is staged as soft tissue sarcoma.

When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in the vagina and has not spread to other parts of the body. Regional means close to the vagina or around it. Distant means in a part of the body farther from the vagina.

Stage 0 is not included in the FIGO system. Stage 0 is also called vaginal intraepithelial neoplasia 3 (VAIN 3) or carcinoma in situ. In VAIN 3, the cancer cells are only in the lining of the vagina and have not spread into the deeper layers of the vagina.

Find out more about staging cancer.

Stage 1

The tumour is in the vagina.

Stage 2

The tumour has grown into tissues next to the vagina (paravaginal tissues) but not into the wall of the pelvis or other nearby organs.

Stage 3

The cancer has grown into the wall of the pelvis and may have spread to nearby lymph nodes.

Stage 4A

The cancer has grown into the bladder, rectum or other tissues outside of the pelvis.

Stage 4B

The cancer has spread to other parts of the body (called distant metastasis), such as to the lungs, liver or bone. This is also called metastatic vaginal cancer.

Recurrent vaginal cancer

Recurrent vaginal cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.

Expert review and references

  • Brierley JD, Gospodarowicz MK, Wittekind C (eds.). TNM Classification of Malignant Tumours. 8th ed. Wiley Blackwell; 2017.
  • Klopp AH, Eifel PJ, Berek JS, Konstantinopoulos PA . Cancer of the cervix, vagina and vulva. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 72:1013-1047.
  • Levine DA, Dizon DS, Yashar CM, Barakat RR, Berchuch A, Markman M, Randall ME. Handbook for Principles and Practice of Gynecologic Oncology. 2nd ed. Philadelphia, PA: Wolters Kluwer; 2015.
  • National Cancer Institute. Vaginal Cancer Treatment for Health Professionals (PDQ®). 2015:
  • Oleszewski K . Vulvar and vaginal cancer. Yarbro, CH, Wujcki D, & Holmes Gobel B. (eds.). Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2011: 69: pp. 1719-1739.

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