FIGO Stage 5 Does Not Exist in Gynecologic Cancer Staging
There is no FIGO stage 5 in any gynecologic cancer staging system. The FIGO (Fédération Internationale de Gynécologie et d'Obstétrique) staging classification for all gynecologic malignancies—including cervical, endometrial, ovarian, vaginal, and vulvar cancers—uses a maximum of four stages (I through IV), with substages designated by letters and numbers. 1
Maximum FIGO Stage Across Gynecologic Cancers
Cervical Cancer
- Stage IV is the highest stage, defined as tumor invasion of the bladder or rectal mucosa, or extension beyond the true pelvis 1
- Stage IVA: tumor invades bladder/rectal mucosa or extends beyond true pelvis 1
- Stage IVB: distant metastases including inguinal lymph nodes and intraperitoneal disease 1
Endometrial Cancer
- Stage IV is the highest stage, encompassing invasion of neighboring organs or distant metastases 1, 2, 3
- Stage IVA: tumor invasion of bladder and/or bowel mucosa 1, 2
- Stage IVB: distant metastases including intra-abdominal or inguinal lymph nodes 1, 2
Ovarian Cancer
- Stage IV is the highest stage, defined as growth involving one or both ovaries with distant metastases 1
- Positive pleural effusion requires positive cytology to designate stage IV 1
- Parenchymal liver metastasis equals stage IV 1
Historical Context of FIGO Staging
- The FIGO staging system was developed around the turn of the 20th century, initially for cervical carcinoma 4
- The system has evolved over decades, with most gynecologic cancers (except cervical and gestational trophoblastic neoplasia) shifting from clinical to surgical-pathological staging 4
- The most recent updates include the 2009 FIGO system for endometrial cancer and the 2023 revision that incorporates molecular and histological factors 5
Common Pitfall
If you encounter a reference to "FIGO stage 5," this represents either a documentation error, miscommunication, or confusion with another staging system. The correct approach is to clarify the actual stage using the established four-stage FIGO classification and verify the primary tumor site, as staging criteria differ between gynecologic cancer types. 1