According to FIGO (The International Federation of Gynecology and Obstetrics), staging should be determined surgically. Patients not operated primarily should be staged based on the following methods: inspection, colposcopy, palpation under general anesthesia, biopsies, currettage, cystoscopy, rigid sigmoidoscopy, chest X-ray, bone X-ray, and urography.
If the stage is uncertain, the lowest alternative should be chosen.
Findings on MRI, CT, and ultrasound may influence the choice of treatment, but should not change the stage.
In order to classify vaginal cancer, the primary growth of tumor must be in the vagina. Tumors that involve the cervix should be classified as cervical cancer. Tumor that involves the vulva should be classified as vulvar cancer. Cancer limited to the urethra should be classified as urethral cancer.
Staging according to FIGO
Stage I: Tumor limited to the vaginal wall.
Stage II: Infiltration of paravaginal tissues, but does not extend beyond the pelvic wall.
Stage III: Infiltration extends to the pelvic wall (attached infiltrate).
Stage IV: Infiltration of mucosa of the bladder or rectum, and/or extends outside the pelvis or distant metastases.
Stage IVa: Infiltration of neighboring organs.
Stage IVb: Distant metastases.