As a patient, the stage of your ovarian cancer tumor will guide your treatment and have an impact on prognosis.

What is Stage?

Cancer stage is an assessment of how far the tumor has spread.

When is Stage Determined?

Definitive diagnosis of ovarian tumors requires surgery to obtain the ovarian tissue for the pathologist. The surgeon will also assess the stage of the tumor i.e. how far the disease has spread. Together with the pathologist's report, this information will help identify the appropriate treatment.

Determining Stage

The following Tumor (T), Lymph node (N) and Metastasis (M) stage and FIGO stage are based on the AJCC Cancer Staging Manual, 8th Edition.

Primary tumor (pT) What It Means
pT1 (I) Tumor is confined to ovaries/fallopian tubes
pT1a (IA) Tumor limited to 1 ovary/fallopian tube (capsule intact); no tumor on ovarian/fallopian tube surface; no malignant cells in the ascites or peritoneal washings
pT1b (IB) Tumor limited to both ovaries/fallopian tubes (capsules intact); no tumor on ovarian/fallopian tube surface; no malignant cells in the ascites or peritoneal washings
pT1c (IC) Tumor limited to 1 or both ovaries/fallopian tubes, with any of the following:
pT1c1 (IC1): Surgical spill
pT1c2 (IC2): Capsule ruptured before surgery or tumor on ovarian/fallopian tube surface
pT1c (IC3): Malignant cells in the ascites or peritoneal washings
pT2 (II) Tumor involves 1 or both ovaries/fallopian tubes with pelvic extension (below pelvic brim)
pT2a (IIA) Extension and/or implants on uterus and/or ovaries and/or fallopian tubes
pT2b (IIB) Extension to and/or implants on other pelvic intraperitoneal tissues
pT3 (III) Tumor involves 1 or both ovaries/fallopian tubes, with microscopically confirmed spread to the peritoneum outside the pelvis and/or metastasis to the retroperitoneal (pelvic and/or para-aortic) lymph nodes
pT3a (IIIA2) Microscopic extrapelvic (above the pelvic brim) peritoneal involvement with or without positive retroperitoneal lymph nodes
pT3b (IIIB) Macroscopic peritoneal metastasis beyond the pelvis up to 2 cm in greatest dimension, with or without metastasis to the retroperitoneal lymph nodes
pT3c (IIIC) Macroscopic peritoneal metastasis beyond the pelvis >2 cm in greatest dimension, with or without metastasis to the retroperitoneal lymph nodes (includes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ)
Regional Lymph Nodes (pN) What It Means
pNX (---) Regional lymph nodes cannot be assessed
pN0 (---) No regional lymph node metastasis
pN0(i+) [---] Isolated tumor cells in regional lymph node(s) no greater than 0.2 mm
IIIA1 Positive retroperitoneal lymph nodes only (histologically proven)
pN1a (IIIA1i) Metastasis up to 1 cm in greatest dimension
pN1b (IIIA1ii) Metastasis >1 cm in greatest dimension
Distant Metastasis (pM) What It Means
pM1 (IV) Distant metastasis, including pleural effusion with positive cytology; liver or splenic parenchymal metastasis; metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); and transmural involvement of intestine
pM1a (IVA) Pleural effusion with positive cytology
pM1b (IVB) Liver or splenic parenchymal metastasis; metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); and transmural involvement of intestine
pT2b (IIB) Macroscopic peritoneal metastasis beyond the pelvis up to 2 cm in greatest dimension, with or without metastasis to the retroperitoneal lymph nodes