Stages and grades

The stage and grade of a cancer helps your doctor decide which treatment you need.

What stage means

The stage tells the doctor how large the cancer is and how far it has spread.

You have tests and scans when the doctors are diagnosing cancer. This gives information about the stage. It is important because doctors plan your treatment according to the stage of the cancer.

There are different ways of staging vulval cancers.

TNM (tumour, node, metastasis) and number staging system

One staging system is the TNM (tumour, node, metastasis) and number system. Stage 0 is the earliest stage and stage 4 is the most advanced. Generally, the earlier the doctor diagnoses cancer, the more likely it is to be successfully treated and cured.

FIGO staging system

In the UK, doctors often stage vulval cancer according to the FIGO (International Federation of Gynaecology and Obstetrics) system. There are 4 main stages in this system.

Recurrent disease means that the cancer has come back (recurred) after treatment. It may come back in the vulva (local recurrence) or in another part of the body.

What grade means

Grading is a way of dividing cancer cells into groups depending on how much the cells look like normal cells. This gives your doctor an idea of how quickly or slowly the cancer might grow and whether it is likely to spread.

Grade 1
The cells look very like normal cells. They are also called low grade or well differentiated. They tend to be slow growing and are less likely to spread than higher grade cancer cells.

Grade 2
The cells look more abnormal and are more likely to spread. This grade is also called moderately differentiated or moderate grade.

Grade 3
The cells look very abnormal and not like normal cells. They tend to grow quickly and are more likely to spread. They are called poorly differentiated or high grade.

Doctors tend to look at stage and grade together in order to decide on the best treatment for you.

Last reviewed: 
11 Jun 2019
  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2017

  • Cancer of the Vulva

    FIGO cancer report 2018

    L Rogers and M Cuello

    International Journal of Gynaecology and Obstetrics, 2018. Vol 143, Issue S2, Pages 4-13

  • Staging for Vulval Cancer
    N Hacker and Others
    Best Practice and Research Clinical Obstetrics and Gynaecology, 2015. Vol 29, Pages 802-811

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