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How is ovarian cancer staged?

Barbara A. Goff, MD
Gynecologic Oncology
The only way to prevent ovarian cancer is to have your tubes and ovaries removed however there are significant risks associated with the procedure and the loss of the hormonal function of the ovaries. Therefore, the pros and cons of prophylactic removal of the fallopian tubes and ovaries needs to be carefully discussed with your physician. In general for women without a family history of breast, ovarian, fallopian tube, or colon cancer prophylactic surgery is not recommended because the harms probably outweigh the benefits.
Other things that can reduce the risk of getting ovarian cancer include tubal ligation, pregnancy and birth control pills.
David A. Fishman, MD
Gynecologic Oncology
Staging for ovarian cancer is based on operative findings confirmed by pathological assessment. The factors that determine ovarian cancer staging include: the size of the tumor, whether the tumor has grown into other tissues or has metastasized to other areas of the body, and whether the lymph nodes have cancer. The staging and sub-grouping of ovarian cancer enables a physician to recommend optimal treatment plans and discuss the expected future outcome (prognosis) with the patient, based on the stage, tumor histology and grade, and the patient's comorbid medical condition.
Ovarian cancer staging is done during surgery, and generally requires removing lymph nodes, samples of tissue from the diaphragm and other abdominal organs, and fluid from the abdomen.

The ovarian cancer staging process uses the TNM system:
  • Tumor (T) describes the size of the original tumor.
  • Lymph Node (N) indicates whether the cancer is present in the lymph nodes.
  • Metastasis (M) refers to whether cancer has spread to other parts of the body, usually the liver, bones or brain.
Once the T, N and M scores have been assigned, an overall ovarian cancer stage is assigned.

Staging for ovarian cancer:

Stage 1 – The cancer is limited to one or both ovaries
  • 1A - Cancer is confined to one ovary. No cancer cells are present on the surface of the ovary or in the pelvis or abdomen.
  • 1B - Cancer is present inside both ovaries, but no cancer cells are present on the surface of the ovaries, in the pelvis or the abdomen.
  • IC - Cancer is present in one or both of the ovaries. In addition, cancer cells are present on the surfaces of one or both ovaries; one tumor has ruptured; or cancer cells are found in fluid samples from the abdomen.
Stage 2 – In this ovarian cancer stage, the disease has spread from the ovary to the pelvic organs, such as the fallopian tubes or uterus.
  • 2A - Cancer is present in one or both of the ovaries and has spread into the uterus or fallopian tubes. No cancer cells are present in the abdomen.
  • 2B - Cancer is present in one or both of the ovaries and has spread to other pelvic organs, such as the bladder, colon or rectum.
  • 2C - Cancer is present in one or both ovaries, and the cancer has spread to the pelvic organs and is found in fluid samples from the abdomen.
Stage 3 – The cancer has spread from the ovary and beyond the pelvis to the abdomen or nearby lymph nodes.
  • 3A - Cancer is present in one or both of the ovaries, and cancer cells are also present in microscopic amounts in the abdominal fluid.
  • 3B - Cancer is present in one or both of the ovaries, and cancer cells are also present in tumors smaller than 2 cm in the abdominal lining.
  • 3C - Cancer is present in one or both of the ovaries, and cancer cells are also present in tumors larger than 2 cm in the abdominal lining or in the nearby lymph nodes.
Stage 4 – In this stage of ovarian cancer, the disease has spread from the ovary to distant sites in the body, such as the liver or lungs.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.