Ovarian Cancer Staging

Staging Systems

There are two staging systems for ovarian cancer: the FIGO (International Federation of Gynecology and Obstetrics) system and the AJCC (American Joint Committee on Cancer) TNM staging system. Both use clinical, lymphatic, and metastatic information to assign stage. Ovarian, fallopian tube, and primary peritoneal cancers are all staged the same way.

The FIGO ovarian staging system was updated for cases diagnosed on or after January 1, 2014. It also serves as a staging system for fallopian tubes and primary peritoneal cancers. Note that it is not possible to have Stage I primary peritoneal cancer (this begins at Stage II). See table below for complete FIGO staging information [17].

FIGO Ovarian Cancer Staging

Stage I: Tumor confined to ovaries or fallopian tubes

IA

Tumor limited to 1 ovary or fallopian tube, capsule intact, no tumor on surface, negative washings

IB

Tumor involves both ovaries otherwise like IA

IC

Tumor limited to 1 or both ovaries or fallopian tubes, with any of the following conditions listed in IC1, IC2, or IC3:

IC1

Surgical spill

IC2

Capsule ruptured before surgery or tumor on ovarian or fallopian tube surface

IC3

Malignant cells in the ascites or peritoneal washings

Stage II: Tumor involves 1 or both ovaries or fallopian tubes with pelvic extension (below the pelvic brim) or primary peritoneal cancer

IIA

Extension and/or implant on uterus and/or fallopian tubes and/or ovaries

IIB

Extension to other pelvic intraperitoneal tissues

Stage III: Tumor involves 1 or both ovaries or fallopian tubes, or primary peritoneal cancer, with cytologically or histologically confirmed spread to the peritoneum outside the pelvis and/or metastasis to the retroperitoneal lymph nodes

IIIA1

Positive retroperitoneal lymph nodes only:

IIIA1(i)

Metastasis ≤ 10 mm

IIIA1(ii)

Metastasis > 10 mm

IIIA2

Microscopic extrapelvic (above the pelvic brim) peritoneal involvement ± positive retroperitoneal lymph nodes

IIIB

Macroscopic peritoneal metastasis beyond the pelvis ≤ 2 cm ± positive retroperitoneal lymph nodes.  Includes extension to capsule of liver/spleen

IIIC

Macroscopic peritoneal metastasis beyond the pelvis > 2 cm ± positive retroperitoneal lymph nodes.  Includes extension to capsule of liver/spleen

Stage IV: Distant metastasis excluding peritoneal metastasis

IVA

Pleural effusion with positive cytology

*Note: There are differences between the FIGO staging and AJCC TNM staging systems. For example, isolated tumor cells in regional lymph nodes is assigned N0(i+) in the AJCC ‘N’ Category, but is not assigned a FIGO stage. For information on AJCC TNM staging, please go to https://www.facs.org/quality-programs/cancer-programs/american-joint-committee-on-cancer/External Website Policy.

Updated: June 8, 2018

Suggested Citation

SEER Training Modules: Ovarian Cancer Staging. U.S. National Institutes of Health, National Cancer Institute. Cited 14 September 2026. Available from: https://training.seer.cancer.gov.