NCIt definition : Stage IVA includes: (T1-T2, N3, M0); (T3, Any N, M0). T1: Tumor confined to the vulva
and/or perineum. Multifocal lesions should be designated as such. The largest lesion
or the lesion with the greatest depth of invasion will be the target lesion identified
to address the highest pT stage. Depth of invasion is defined as the measurement of
the tumor from the epithelial-stromal junction of the adjacent most superficial dermal
papilla to the deepest point of invasion. T2: Tumor of any size with extension to
adjacent perineal structures (lower/distal third of the urethra, lower/distal third
of the vagina, anal involvement). T3: Tumor of any size with extension to any of the
following: upper/proximal two-thirds of the urethra, upper/proximal two-thirds of
the vagina, bladder mucosa, or rectal mucosa; or fixed to pelvic bone. N3: Fixed or
ulcerated regional lymph node metastasis. M0: No distant metastasis. (from AJCC 8th
Ed.);