Ovarian Cancer Staging
Ovarian cancer staging requires a surgical technique called a laparotomy.
During a laparotomy a surgical incision is made in the abdomen so the surgeon can visually
examine the ovaries, the pelvic cavity and the abdomen. The surgeon removes as much of the
tumor as possible, along with any lymph nodes
that may be affected. If possible, a qualified gynecologic oncologist should perform the
laparotomy.
A number of imaging techniques may be used to help stage the cancer, including x-rays,
ultrasound and CT scans. A CT scan, or CAT scan, uses x-rays to produce multiple cross
section images or "slices" of the body.
- Stage I - Ovarian 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. (There is no cancer on the outer surface of the ovary.) There is no ascites
present containing malignant cells. The surface of the tumor is unruptured.
- IB - Cancer is limited to both ovaries without any tumor on their outer surfaces.
There is no ascites present containing malignant cells. The surface of the tumor is
unruptured.
- IC - The tumor is classified as either Stage 1A or 1B and one or more of the
following are present: (1) tumor is present on the outer surface of one or both ovaries;
(2) at least one of the tumors has ruptured; and (3) there is ascites present or abdominal
(peritoneal) washings containing malignant cells.
- Stage II - The Ovarian cancer tumor involves one or both ovaries with
extension to other pelvic structures.
- IIA - The cancer has extended to and/or involves the uterus or the fallopian
tubes or both.
- 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 are present: (1) tumor is present on the outer surface of one or both ovaries;
(2) at least one of the tumors has ruptured; and (3) there is ascites containing malignant
cells or with abdominal (peritoneal) washings containing malignant cells.
- Stage III - The ovarian cancer tumor involves one or both ovaries,
and one or both of the following are present: (1) the cancer has spread beyond the pelvis
to the lining of the abdomen; and (2) 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.
- IIIA - During the staging operation, the practitioner can see cancer involving
one or both of the ovaries, but no cancer is grossly visible in the abdomen and it has no
spread to the lymph nodes. However, when biopsies are checked under a microscope, very
small deposits of cancer are found 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 not exceeding 2 cm in
diameter. The cancer has not spread to the lymph nodes.
- IIIC - The tumor is in one or both ovaries, and one or both of the following is
present: (1) the cancer has spread to lymph nodes; (2) the deposits of cancer exceed 2 cm
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) is also evidence of stage IV disease.
The stage of ovarian cancer at diagnosis is also the most important indicator of prognosis
(prediction of duration, course and outcome of the disease)
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Ovarian Cancer Picture
Ovarian Cancer Ultrasound
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