FIGO Staging for Ovarian Cancer (2014)

Classifies ovarian cancer based on tumor location, size, grade and lymph nodes or metastatic spread.

Refer to the text below the calculator for more information about ovarian cancer staging.

The FIGO staging may be used for postoperative assessment in patients with histologically-proven ovarian cancer.

Staging ranges from stage I through to stage IV, where the lower the stage, the more limited the malignancy spread. Each of the four stages may be further classified depending on other tumor characteristics.

The FIGO ovarian cancer staging system uses three main factors to classify the cancer:

The extent of the tumor;
The spread to nearby lymph nodes;
The spread (metastasis) to distant sites.

Tumor location

Stage I: Tumor confined to ovaries

Stage II: Tumor involves 1 or both ovaries with pelvic extension (below the pelvic brim) or primary peritoneal cancer

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

Stage IV: Distant metastasis excluding peritoneal metastasis

Send Us Your Feedback

Steps on how to print your input & results:

1. Fill in the calculator/tool with your values and/or your answer choices and press Calculate.

2. Then you can click on the Print button to open a PDF in a separate window with the inputs and results. You can further save the PDF or print it.

Please note that once you have closed the PDF you need to click on the Calculate button before you try opening it again, otherwise the input and/or results may not appear in the pdf.

Ovarian Cancer – FIGO Staging Explained

The FIGO staging may be used for postoperative assessment in patients with histologically-proven ovarian cancer.

Ovarian cancer description			FIGO Stage
Stage I: Tumor confined to ovaries	Tumor limited to 1 ovary, capsule intact, no tumor on surface, negative washings		Stage IA
	Tumor involves both ovaries otherwise like above		Stage IB
	Tumor limited to 1 or both ovaries	Surgical spill	Stage IC1
		Capsule rupture before surgery or tumor on ovarian surface	Stage IC2
		Malignant cells in the ascites or peritoneal washings	Stage IC3
Stage II: Tumor involves 1 or both ovaries with pelvic extension (below the pelvic brim) or primary peritoneal cancer	Extension and/or implant on uterus and/or fallopian tubes		Stage IIA
	Extension to other pelvic intraperitoneal tissues		Stage IIB
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	Positive retroperitoneal lymph nodes and/or microscopic metastasis beyond the pelvis	Positive retroperitoneal lymph nodes only (Metastasis ≤10 mm)	Stage IIIA1(i)
		Positive retroperitoneal lymph nodes only (Metastasis >10 mm)	Stage IIIA1(ii)
		Microscopic, extrapelvic (above the brim) peritoneal involvement ± positive retroperitoneal lymph nodes	Stage IIIA2
	Macroscopic, extrapelvic, peritoneal metastasis ≤2 cm ± positive retroperitoneal lymph nodes; includes extension to capsule of liver/spleen		Stage IIIB
	Macroscopic, extrapelvic, peritoneal metastasis >2 cm ± positive retroperitoneal lymph nodes; includes extension to capsule of liver/spleen		Stage IIIC
Stage IV: Distant metastasis excluding peritoneal metastasis	Pleural effusion with positive cytology		Stage IVA
	Hepatic and/or splenic parenchymal metastasis, metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside of the abdominal cavity)		Stage IVB

Other recommendations accompanying the FIGO staging may include:

Primary site (ovary, Fallopian tube or peritoneum) should be designated where possible;
Histologic type including grading should be designated at staging;
Tumors that may otherwise qualify for stage I but where dense adhesions are present, may justify upgrading to stage II if the adhesions are histologically proven to contain tumor cells.

The FIGO staging system agrees with the World Health Organization histologic typing of epithelial ovarian tumours and fallopian tube and peritoneal neoplasia as follows:

Serous tumours;
Mucinous tumours;
Endrometrioid tumours;
Clear cell tumours;
Brenner tumours;
Undifferentiated carcinomas;
Mixed epithelial tumours;
Peritoneal carcinoma or serous carcinoma of undesignated site (where the ovaries and fallopian tubes appear to be incidentally involved and not the primary origin).

There is another staging system, the AJCC (American Joint Committee on Cancer) TNM staging system, which is very similar to the FIGO, because both systems use three main factors to classify the cancer:

The extent of the tumor;
The spread to nearby lymph nodes;
The spread (metastasis) to distant sites.

References

Original reference

Prat J; FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. 2014; 124(1):1-5.

Other references

Prat J; FIGO Committee on Gynecologic Oncology. Staging Classification for Cancer of the Ovary, Fallopian Tube, and Peritoneum: Abridged Republication of Guidelines From the International Federation of Gynecology and Obstetrics (FIGO). Obstet Gynecol. 2015; 126(1):171-174.

Heintz AP, Odicino F, Maisonneuve P, et al. Carcinoma of the ovary. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006; 95 Suppl 1:S161-S192.

Specialty: Oncology

System: Reproductive

Objective: Staging

Year Of Study: 2014

Article By: Denise Nedea

Published On: September 26, 2020 · 12:00 AM

Last Checked: September 26, 2020

Next Review: September 26, 2025