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Staging of ovarian and fallopian tube cancer

Ovarian cancer

According to FIGO (The International Federation of Gynecology and Obstetrics), staging should be done surgically. A chest X-ray should be taken.

Staging according to FIGO

 

Stage I: Tumor limited to the ovaries.

  • Stage Ia: Tumor limited to one ovary. 
  • Stage Ib: Tumor in both ovaries.
  • Stage Ic: Tumor limited to one or both ovaries with any of the following: capsule ruptured, tumor on ovarian surface, malignant cells in ascites or peritoneal washings. 

 

 Stage II: Tumor involves one or both ovaries with pelvis extension

  • Stage IIa: Tumor invasion/metastasis to uterus and/tube(s)
  • Stage IIb: Tumor invasion/metastasis to other tissue pelvic tissues
  • Stage IIc: Tumor in stage IIa–IIb with tumor on surface of ovaries and/or capsule ruptured and/or tumor cells in ascites or peritoneal washings 

 

Stage III: Metastasis outside the pelvis but limited to the abdominal cavity and/or spreading to retroperitoneal lymph nodes (pelvis or paraaortal) or inguinal 

  • Stage IIIa: Microscopic tumor spreading to upper part of the abdominal cavity
  • Stage IIIb: Metastases smaller than 2 cm in upper abdominal cavity
  • Stage IIIc: Metastases larger than 2 cm in upper abdominal cavity to paraaortal or inguinal lymph nodes   

Stage IV: Distant metastasis and/or pleural fluid with malignant cells. Parenchymal liver metastases.  

Adnexa uteri Stadium IV 

Fallopian tube cancer

Staging according to FIGO

According to FIGO (The International Federation of Gynecology and Obstetrics), surgical staging should be done. A chest X-ray should be taken also. 

Stage 0: Carcinoma in situ (limited to tubal mucosa)

Stage I: Tumor limited to fallopian tubes

 

  • Stage Ia: Tumor confined to one fallopian tube with metastasis to submucosa and/or muscle, without penetrating serosal surface; no ascites.
  • Stage Ib: Tumor confined to both tubes, without penetrating the serosal surface; no ascites. 
  • Stage Ic: Tumor confined to one or both tube(s) with extension into or through the tubal serosa, or with malignant cells is ascites or peritoneal washings   

 

Stage II: Tumor in one or both fallopian tube(s) with metastasis in the pelvis  

  • Stage IIa: Tumor in one or both fallopian tube(s) with metastasis to the uterus and/or ovaries 
  • Stage IIb: Tumor in one or both ovaries with spreading to other pelvic structures
  • Stage IIc: Tumor stage IIa or IIb with malignant cells in ascites or peritoneal washings 

 

Stage III: Metastasis outside the pelvis, but confined to abdominal cavity and/or metastasis to retroperitoneal lymph nodes (pelvic or paraaortal) or inguinal

  • Stage IIIa: Microscopic metastasis to upper abdominal cavity
  • Stage IIIb: Metastases smaller than 2 cm in upper abdominal cavity
  • Stage IIIc: Metastases larger than 2 cm in upper abdominal cavity, or metastases to paraaortal or inguinal lymph nodes

Stage IV: Distant metastases and/or pleural fluid containing malignant cells. Parenchymal liver metastases. 

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