Stages

The stages of Ovarian Cancer are determined by how far the cancer has spread. The stage of Ovarian Cancer at diagnosis is the most important indicator of prognosis.

stages

Stage I
Cancer is limited to one or both ovaries.

IA
Cancer is limited to one ovary and the tumor is confined to the inside of the ovary. No ascites containing malignant cells is present, and the surface of the tumor has not ruptured.

IB
Cancer is limited to both ovaries without any tumors on the ovaries’ outer surfaces. No ascites containing malignant cells is present, and the surface of the tumor has not ruptured.

IC
The tumor is classified as either Stage IA or IB and one or more of the following conditions exist:

  • a tumor on the outer surface of one or both ovaries;
  • at least one ruptured tumor;
  • ascites or abdominal (peritoneal) washings containing malignant cells.

Stage II
The tumor involves one or both ovaries and extends to other pelvic structures.

IIA
The cancer has extended to and/or involves the uterus and/or the fallopian tubes.

IIB
The cancer has extended to the bladder or rectum.

IIC
The tumor is classified as either Stage IIA or IIB and one or more of the following conditions exist:

  • a tumor on the outer surface of one or both ovaries;
  • at least one ruptured tumor;
  • ascites containing malignant cells or abdominal (peritoneal) washings containing malignant cells.

Stage III
The tumor involves one or both ovaries, and one or both of the following exist:

  • The cancer has spread beyond the pelvis to the lining of the abdomen;
  • The cancer has spread to the lymph nodes. The tumor is limited to the true pelvis but with histologically-proven malignant extension to the small bowel or omentum (peritoneum fold).

IIIA
The tumor is in one or both of the ovaries. While surgeons cannot see cancer in the abdomen, and the cancer has not spread to the lymph nodes, biopsies checked under a microscope reveal tiny deposits of cancer in the abdominal (peritoneal) surfaces.

IIIB
The tumor is in one or both ovaries, and deposits of cancer are present in the abdomen that are large enough for the surgeon to see but do not exceed 2cm in diameter. The cancer has not spread to the lymph nodes.

IIIC
The tumor is visible in one or both ovaries, and one or both of the following conditions exists:

  • the cancer has spread to lymph nodes;
  • the deposits of cancer exceed 2cm in diameter and are found in the abdomen.

Stage IV
Growth of the cancer involves one or both ovaries and distant metastases to the liver or lungs have occurred.

Finding Ovarian Cancer cells in the excess fluid accumulated around the lungs (pleural fluid) also shows evidence of Stage IV.