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Ovarian cancer staging

Dr Henry Knipe and Radswiki et al.

The most commonly adopted ovarian cancer staging system is the FIGO staging system:

  • stage I:  tumour limited to the ovaries
    • stage Ia: tumour limited to one ovary; capsule intact, no tumour on ovarian surface; no malignant cells in ascites or peritoneal washings
    • stage Ib: tumour limited to both ovaries; capsules intact, no tumour on ovarian surface; no malignant cells in ascites or peritoneal washings
    • stage Ic: tumor limited to one or both ovaries , with any of the following: 
      • stage Ic1: surgical spill
      • stage Ic2: capsule ruptured before surgery, or tumour on ovarian or fallopian tube surface
      • stage Ic3: malignant cells in the ascites or peritoneal washings
  • stage II: tumour involves one or both ovaries with pelvic extension (below pelvic brim)
    • stage IIa: extension or implants on the uterus or fallopian tubes, no malignant ascites/negative peritoneal washings
    • stage IIb: extension to other pelvic intraperitoneal tissues
  • stage III: tumour involves one or both ovaries with cytologically or histologically confirmed spread to the peritoneum outside the pelvis and/or metastasis to the retroperitoneal lymph nodes
    • stage IIIa: positive retroperitoneal lymph nodes and /or microscopic metastasis beyond the pelvis:
      • stage IIIa1: positive (cytologically or histologically proven) retroperitoneal lymph nodes only
        • stage IIIa1(i): metastasis up to 10 mm in greatest dimension
        • stage IIIa1(ii): metastasis more than 10 mm in greatest dimension
      • stage IIIa2: microscopic extrapelvic (above the pelvic brim) peritoneal involvement with or without positive retroperitoneal lymph nodes
    • stage IIIb: involves macroscopic peritoneal metastasis beyond the pelvis up to 2 cm in greatest dimension, with or without metastasis to the retroperitoneal lymph nodes
    • stage IIIc: involves macroscopic peritoneal metastasis beyond the pelvis more than 2 cm in greatest dimension, with or without metastasis to the retroperitoneal lymph nodes
      • includes extension of tumor to the capsule of liver and spleen without parenchymal involvement of either organ
  • stage IV: consists of distant metastasis, excluding peritoneal metastases, and includes the following:
    • stage IVa: pleural effusion with positive cytology
    • stage IVb: parenchymal metastases and metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside of the abdominal cavity)

See also

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