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Cancer Staging Systems
Staging of Epithelial Ovarian Cancer
Last Update: Sunday January 4th, 2004 7:15 PM GMT
The Federation Internationale de Gynecologie et d’Obstetrique (FIGO) and
the American Joint Committee on Cancer (AJCC) staging system
Stage I
Stage I ovarian cancer is limited to the ovaries.
- Stage IA: Tumor limited to 1 ovary; capsule intact, no
tumor on ovarian surface. No malignant cells in
ascites or peritoneal
washings.
- Stage IB: Tumor limited to both ovaries; capsules intact,
no tumor on ovarian surface. No malignant cells in
ascites or peritoneal
washings.
- Stage IC: Tumor limited to 1 or both ovaries with any
of the following: capsule ruptured, tumor on ovarian surface, malignant
cells in
ascites or peritoneal washings.
Stage II
Stage II ovarian cancer is tumor involving 1 or both ovaries with pelvic
extension and/or implants.
- Stage IIA: Extension and/or implants on the uterus and/or
fallopian tubes. No malignant cells in
ascites or peritoneal washings.
- Stage IIB: Extension to and/or implants on other pelvic
tissues. No malignant cells in ascites or peritoneal washings.
- Stage IIC: Pelvic extension and/or implants (stage IIA
or IIB) with malignant cells in
ascites or peritoneal washings.
Different criteria for allotting cases to stages IC and IIC have an impact
on diagnosis. In order to evaluate this impact, it would be of value to
know if rupture of the capsule was (1) spontaneous or (2) caused by the
surgeon, and if the source of malignant cells detected was (1) peritoneal
washings or (2)
ascites.
Stage III
Stage III ovarian cancer is tumor involving 1 or both ovaries with microscopically
confirmed peritoneal implants outside the pelvis. Superficial liver metastasis
equals stage III. Tumor is limited to the true pelvis but with histologically
verified malignant extension to small bowel or omentum.
- Stage IIIA: Microscopic peritoneal metastasis beyond pelvis
(no macroscopic tumor).
- Stage IIIB: Macroscopic peritoneal metastasis beyond pelvis
2 cm or less in greatest dimension.
- Stage IIIC: Peritoneal metastasis beyond pelvis more than
2 cm in greatest dimension and/or regional lymph node metastasis.
Stage IV
Stage IV ovarian cancer is tumor involving 1 or both ovaries with distant
metastasis. If pleural effusion is present, there must be positive cytologic
test results to designate a case to stage IV. Parenchymal liver metastasis
equals stage IV.
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References
- Shepherd JH: Revised FIGO staging for gynaecological cancer. Br J
Obstet Gynaecol 96 (8): 889-92, 1989.
- Ovary. In: American Joint Committee on Cancer.: AJCC Cancer Staging
Manual. 6th ed. New York, NY: Springer, 2002, pp 275-284.
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