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SEER Training Modules

Ovarian Cancer Staging

Criteria for TNM Clinical Staging:
Physical examination and history; palpation of abdomen, imaging, histologic confirmation of malignancy and laparoscopy or laparotomy evaluation.

Criteria for TNM Pathologic Staging:
Laparotomy, hysterectomy and resection of ovarian masses, plus biopsies of pelvic and paraaortic nodes, liver, diaphragm, omentum, and/or mesentery if suspicious for tumor.

Staging for ovarian carcinoma is limited to malignant epithelial tumors only.

Brief Summaries of 6th Edition and FIGO Categories

Ovary
AJCC FIGO Definition
T1 I Limited to ovaries
T1a IA One ovary, capsule intact
T1b IB Both ovaries, capsule intact
T1c IC Capsule ruptured, tumor on surface, malignant cells in ascites or peritoneal washings
T2 II Pelvic extension
T2a IIA Uterus, tube(s)
T2b IIB Other pelvic tissues
T2c IIC Malignant cells in ascites or peritoneal washings
T3/N1 III Peritoneal metastasis beyond pelvis
T3a IIIA Microscopic peritoneal metastasis
T3b IIIB Macroscopic peritoneal metastasis <=2 cm
T3c IIIC Peritoneal metastasis > 2 cm and/or
N1 IIIC Regional lymph node metastasis (with Any T)
M1 IV Distant metastasis (excluding peritoneal metastasis)
Fallopian Tube
AJCC FIGO Definition
T1 I Limited to tube(s)
T1a IA One tube, serosa intact, no ascites
T1b IB Both tubes, serosa intact, no ascites
T1c IC Serosa penetrated, malignant cells in ascites or peritoneal washings
T2 II Pelvic extension
T2a IIA Extension and/or metastasis to uterus and/or ovaries
T2b IIB Extension to other pelvic structures
T2c IIC Extension with malignant cells in ascites or peritoneal washings
T3 III Peritoneal implants beyond pelvis
T3a IIIA Microscopic peritoneal outside pelvis
T3b IIIB Macroscopic peritoneal metastasis outside pelvis <=2 cm
T3c IIIC Peritoneal metastasis > 2 cm and/or
N1 IIIC Regional lymph node metastasis (with Any T)
M1 IV Distant metastasis (excluding peritoneal cavity metastasis)

Collaborative Stage Elements

For more details on Collaborative Stage, see the Intro to Collaborative Staging module.