The prevalence of the process

The spread of the tumor in the body is an important criterion in choosing the most appropriate treatment for patients. Therefore, for a more accurate description, depending on the degree of prevalence of the process, tumors are divided into stages.

Classification is carried out in accordance with certain standards, for which, above all, three main aspects are decisive:

• Tumor size (T)
• Involvement of lymph nodes (N)
• Presence of metastases (M)

Therefore, the term TNM classification is also used. The numbers after the letter give a more accurate idea of the size and extent of the tumor (T1-4), the number and location of affected lymph nodes (N0-1) and the presence or absence of distant metastases (M0 and M1). T1 N0 M0 would mean in this case that we are talking about a small tumor without the presence of affected lymph nodes and distant metastases. An accurate assessment of the TNM stage is possible only after surgical removal of the tumor. Thus, in patients after radiotherapy, an accurate assessment of the TNM stage is not performed.

Along with the TNM system, there is a further staging classification for female cancers, the so-called FIGO classification. It also takes into account the local spread of the tumor, the involvement of neighboring organs and lymph nodes in the process, as well as metastases to distant organs. This classification is used in parallel with the TNM classification and is necessary for international comparison of the received data. Since 01/01/2010, the 7th revised TNM-/FIGO classification has been in force. It takes into account modern scientific knowledge about the impact of the prevalence of the tumor process and some other factors on the prognosis of cervical cancer.

Note

The above described surgical staging does not count towards the TNM/FIGO criteria. However, it is of great importance for therapy. Another important criterion in drawing up a treatment plan is the presence of a tendency for cancerous tissue to grow (Grading-stage). This is determined by microscopic examination of tissue taken from a biopsy, and is divided into stages from I to III. In addition, histological risk factors are established that characterize the aggressiveness and local spread of the disease. They include tumor invasion into small blood vessels (V), lymphatics (L), and surrounding nerve tissue, into the perineural sheath.

Determination of the spread of the tumor in the body and the result of a histological examination help the doctor in choosing a method of treatment.