FIGO Staging of Ovarian Cancer (2014)
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STAGE I
IA
IB
IC
IC1
IC2
IC3
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Tumor confined to ovaries
Tumor limited to 1 ovary, capsule intact, no tumor on surface, negative washings.
Tumor involves both ovaries otherwise like IA.
Tumor limited to 1 or both ovaries
Surgical spill
Capsule rupture before surgery or tumor on ovarian surface
Malignant cells in the ascites or peritoneal washings.
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STAGE II
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Tumor involves 1 or both ovaries with pelvic extension (below the pelvic brim) or primary peritoneal cancer
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IIA
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Extension and/or implant on uterus and/or Fallopian tubes
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IIB
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Extension to other pelvic intraperitoneal tissues
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STAGE III
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Tumor involves 1 or both ovaries with cytologically or histologically confirmed spread to the peritoneum outside the pelvis and/or metastasis to the retroperitoneal lymph nodes
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IIIA1
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Positive retroperitoneal lymph nodes only
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IIIA1 (i)
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Metastasis ≤ 10 mm
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IIIA1 (ii)
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Metastasis > 10 mm
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IIIA2
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Microscopic, extra-pelvic (above the brim) peritoneal involvement ± positive retroperitoneal lymph nodes
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IIIB
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Macroscopic, extra-pelvic, peritoneal metastasis ≤ 2 cm ± positive retroperitoneal lymph nodes. Includes extension to capsule of liver/spleen.
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IIIC
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Macroscopic, extra-pelvic, peritoneal metastasis > 2 cm ± positive retroperitoneal lymph nodes. Includes extension to capsule of liver/spleen
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STAGE IV
IVA
IVB
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Distant metastasis excluding peritoneal metastasis
Pleural effusion with positive cytology
Hepatic and/or splenicparenchymal metastasis, metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside of the abdominal cavity)
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Other major recommendations are as follows:
- Histologic type including grading should be designated at staging
- Primary site (ovary, Fallopian tube or peritoneum) should be designated where possible
- Tumors that may otherwise qualify for stage I but involved with dense adhesions justify upgrading to stage II if tumor cells are histologically proven to be present in the adhesions