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Understanding Your Stage of Ovarian Cancer

The stage of your cancer is a way doctors describe to what extent the cancer has spread. The stage of ovarian cancer is usually determined after surgery, by examining the removed tissue in the pathology lab. This is known as "surgically staging" the ovarian cancer. Ovarian cancer is staged using the AJCC and FIGO system. AJCC stands for American Joint Committee on Cancer. FIGO stands for International Federation of Gynecology and Obstetrics. These two staging systems are a lot alike. Both define cancers by Roman numerals 0 through IV. The lower the stage, the less the cancer has spread. The higher the stage, the more the cancer has spread. These are the stages of ovarian cancer and their definitions. Be sure to ask your doctor to explain your cancer’s stage to you. Gynecologic oncologists are specialists who have done extra training in the diagnosis and treatment of gynecologic cancers.

Stage I

Cancer is in one or both of the ovaries and has not spread. Stage I is further divided into three stages.

Stage IA. Cancer is in a single ovary and has not spread onto the outer surface of the ovary. Doctors have not found cancer cells in fluid or washings from the abdomen or pelvis.

Stage IB. Cancer is in both ovaries and has not spread to their outer surfaces. Doctors have not found cancer cells in fluid or washings from the abdomen or pelvis.

Stage IC. The cancer is present in one or both ovaries, and at least one of these three facts is also true.

  • Cancer is on the outer surface of at least one of the ovaries.

  • The outer wall of a fluid-filled tumor, called a cystic tumor, has ruptured.

  • Cancer cells have been found in fluid or washings from the abdomen or pelvis.

Stage II

Cancer is in one or both ovaries and has grown onto or into other pelvic organs. These might include the uterus, fallopian tubes, bladder, sigmoid colon, or rectum. The cancer has not spread to lymph nodes, the lining of the abdomen, or distant organs. Stage II is further divided into three stages.

Stage IIA. The cancer has spread onto or into the uterus or the fallopian tubes, or both. Doctors have not found cancer cells in fluid or washings from the abdomen or pelvis.

Stage IIB. The cancer has spread onto or grown into other organs within the pelvis, such as the bladder, sigmoid colon, or rectum. Doctors have not found cancer cells in fluid or washings from the abdomen or pelvis.

Stage IIC. The cancer has spread to the uterus, fallopian tubes, or other organs within the pelvis. Doctors have also found cancer cells in fluid or washings from the abdomen or pelvis.

Stage III

The cancer is in one or both ovaries. Also, one or both of these things has occurred.

  • Cancer has spread to the abdominal lining.

  • Cancer has spread to the lymph nodes.

Stage III is further divided into three stages.

Stage IIIA. Cancer is visible in one or both ovaries. In addition, cancerous cells are found in the abdominal lining, but the cancer there is too small to be seen with the naked eye. The cancer has not spread to the lymph nodes.

Stage IIIB. Cancer is in one or both ovaries, and there are small, visible cancerous deposits, which are less than 2 centimeters (cm) across, in the abdomen. (Two cm is about 0.8 inch.) Cancer has not spread to the lymph nodes.

Stage IIIC. Cancer is in one or both ovaries and one or both of these cases is true.

  • Cancer has spread to the lymph nodes.

  • Deposits of cancer (larger than 2 cm across) are visible in the abdomen.

Stage IV

The cancer has spread outside the pelvic region to distant sites such as the liver, the lungs, or other organs.

Recurrent ovarian cancer

Cancer has returned after treatment.