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Table 118-4. FIGO Stages for Primary Carcinoma of the Ovary

Table 118-4. FIGO Stages for Primary Carcinoma of the Ovary
Stage I Growth limited to the ovaries
Stage IA Growth limited to the ovary; no ascites. No tumor on the external surface; capsule intact
Stage IB Growth limited to both ovaries; no ascites. No tumor on the external surfaces; capsule intact
Stage IC Tumor either stage 1A or 1B but with tumor on the surface of one or both ovaries; or with capsule ruptured; or with ascites present containing malignant cells or with positive peritoneal washings
Stage II Growth involving one or both ovaries with pelvic extension
Stage IIA Extension and/or metastases to the uterus and/or tubes
Stage IIB Extension to other pelvic tissues
Stage IIC Tumor either stage IIA or IIB with tumor on the surface of one or both ovaries; or with capsule(s) ruptured; or with ascites present containing malignant cells or with positive peritoneal washings
Stage III Tumor involving one or both ovaries and/or positive retroperitoneal or inguinal nodes. Superficial liver metastasis equals stage III. Tumor is limited to the true pelvis, but with histologically proven malignant extension to small bowel or omentum
Stage IIIA Tumor grossly limited to the true pelvis with negative nodes but with histologically confirmed implants of abdominal peritoneal surfaces, none exceeding 2 cm in diameter. Nodes negative
Stage IIIB Tumor of one or both ovaries with histologically confirmed implants of abdominal peritoneal surfaces, none exceeding 2 cm in diameter. Nodes negative
Stage IIIC Abdominal implants more than 2 cm in diameter and/or positive retroperitoneal or inguinal nodes
Stage IV Growth involving one or both ovaries with distant mestastasis. If pleural effusion is present, there must be positive cytologic test results to allot a case to stage IV. Parenchymal liver metastasis equals stage IV.
Adapted from Pecorelli S, Odicino F, Maisonneuve P, et al.53 These categories are based on findings at clinical examination and/or surgical exploration. The histologic characteristics are to be considered in the staging, as are results of cytologic testing as far as effusions are concerned. It is desirable that a biopsy be performed on suspicious areas outside the pelvis. In order to evaluate the impact on prognosis of the different criteria for allotting cases to stage IC or IIC, it would be of value to know if rupture of the capsule was (1) spontaneous or (2) caused by the surgeon, and if the source of malignant cells detected was (1) peritoneal washings or (2) ascites.