FIGO Ovarian Cancer Staging Effective Jan. 1, 2014
FIGO Ovarian Cancer Staging Effective Jan. 1, 2014
(Changes are in italics.)
STAGE I: Tumor confined to ovaries
OLD
NEW
IA Tumor limited to 1 ovary,
IA
Tumor limited to 1 ovary,
capsule intact, no tumor on
capsule intact, no tumor on
surface, negative
surface, negative washings.
washings/ascites.
IB Tumor involves both ovaries
IB
Tumor involves both ovaries
otherwise like IA.
otherwise like IA.
IC Tumor involves 1 or both
IC Tumor limited to 1 or both ovaries
ovaries with any of the
IC1
Surgical spill
following: capsule rupture,
IC2
Capsule rupture before
tumor on surface, positive
surgery or tumor on ovarian
washings/ascites.
surface.
IC3
Malignant cells in the ascites
or peritoneal washings.
STAGE II: Tumor involves 1 or both ovaries with pelvic extension (below the pelvic brim) or primary peritoneal cancer
OLD
IIA Extension and/or implant on
IIA
uterus and/or Fallopian tubes
IIB Extension to other pelvic
IIB
intraperitoneal tissues
IIC IIA or IIB with positive
washings/ascites.
**Old stage IIC has been eliminated**
NEW Extension and/or implant on uterus and/or Fallopian tubes Extension to other pelvic intraperitoneal tissues
1
FIGO Ovarian Cancer Staging Effective Jan. 1, 2014
(Changes are in italics.)
STAGE III: 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
OLD
NEW
IIIA Microscopic metastasis
IIIA ( Positive retroperitoneal lymph nodes and
beyond the pelvis.
/or microscopic metastasis beyond the pelvis)
IIIA1 Positive retroperitoneal lymph nodes only
IIIB Macroscopic, extrapelvic, peritoneal metastasis 2 cm in greatest dimension.
IIIC Macroscopic, extrapelvic, peritoneal metastasis > 2 cm in greatest dimension and/or regional lymph node metastasis.
IIIA2 IIIB IIIC
IIIA1(i) Metastasis 10 mm IIIA1(ii) Metastasis > 10 mm Microscopic, extrapelvic (above the brim) peritoneal involvement ? positive retroperitoneal lymph nodes Macroscopic, extrapelvic, peritoneal metastasis 2 cm ? positive retroperitoneal lymph nodes. Includes extension to capsule of liver/spleen. Macroscopic, extrapelvic, peritoneal metastasis > 2 cm ? positive retroperitoneal lymph nodes. Includes extension to capsule of liver/spleen.
STAGE IV: Distant metastasis excluding peritoneal metastasis
OLD
NEW
IV Distant metastasis excluding
IVA Pleural effusion with positive cytology
peritoneal metastasis. Includes hepatic parenchymal metastasis.
IVB Hepatic and/or splenic parenchymal metastasis, metastasis to extraabdominal organs (including inguinal
lymph nodes and lymph nodes outside of
the abdominal cavity)
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
2
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