复旦大学上海医学院妇产科学系2009级六年制妇产科学课件 Cervical Cancer.ppt

FIGO Staging I The carcinoma is strictly confined to the cervix (extension to the uterine corpus should be disregarded). IA Invasive cancer identified only microscopically. Invasion is limited to measured stromal invasion with a maximum depth of 5mmb and no wider than 7mm. (All gross lesions even with superficial invasion are Stage IB cancers.) IA1: Measured invasion of stroma ≤3mm in depth and ≤7mm width. IA2 : Measured invasion of stroma 3mm and 5mm in depth and ≤7mm width. IB Clinical lesions confined to the cervix, or preclinical lesions greater than stage IA. IB1: Clinical lesions no greater than 4cm in size. IB2: Clinical lesions 4cm in size. II The carcinoma extends beyond the uterus, but has not extended onto the pelvic wall or to the lower third of vagina. IIA Involvement of up to the upper 2/3 of the vagina. No obvious parametrial involvement. IIA1: Clinically visible lesion ≤4cm IIA2: Clinically visible lesion 4cm IIB Obvious parametrial involvement but not onto the pelvic sidewall. III The carcinoma has extended onto the pelvic sidewall. On rectal examination, there is no cancer-free space between the tumor and pelvic sidewall. The tumor involves the lower third of the vagina. All cases of hydronephrosis or non-functioning kidney should be included unless they are known to be due to other causes. IIIA Involvement of the lower vagina but no extension onto pelvic sidewall. IIIB Extension onto the pelvic sidewall, or hydronephrosis/non-functioning kidney. IV The carcinoma has extended beyond the true pelvis or has clinically involved the mucosa of the bladder and/or rectum. IVA Spread to adjacent pelvic organs. IVB Spread to distant organs. Complications of RH Vesicovaginal fistula Ureterovaginal fistula Severe bladder atomy Bowel obstruction Lymphocyst Thrombophlebtis Pulmonary embolus Pregnant with cervical cancer 20w, operation; 20w, evaluation, Ia-Ib1 observation; 24w, 32-34w CS+RH; Prognosis