Ovarian Epithelial Cancer Treatment - Stage Information for Ovarian Epithelial Cancer
Note: The American Joint Committee on Cancer has recently published a new edition of the AJCC Cancer Staging Manual, which includes revisions to the staging for this disease. The PDQ Adult Treatment Editorial Board, which is responsible for maintaining this summary, is currently reviewing the new staging to determine the changes that need to be made in the summary. In addition to updating this Stage Information section, additional changes may need to be made to other parts of this summary to ensure that it is up-to-date. The changes will be made as soon as possible.
In the absence of extra-abdominal metastatic disease, definitive staging of ovarian cancer requires laparotomy. The role of surgery in patients with stage IV disease and extra-abdominal disease is yet to be established. If disease appears to be limited to the ovaries or pelvis, it is essential at laparotomy to examine and biopsy or to obtain cytologic brushings of the diaphragm, both paracolic gutters, the pelvic peritoneum, para-aortic and pelvic nodes, and infracolic omentum, and to obtain peritoneal washings.[1]
Understanding Ovarian Cancer -- Prevention
Depending on your stage of life and risk for ovarian cancer, you should discuss with your doctor the pros and cons of using birth control pills or hormone therapy pills. Low-dose birth control pills are considered protective, but hormone therapy may slightly heighten the risk of ovarian cancer. However, the data for hormone replacement therapy is inconsistent. If you are at high risk for ovarian cancer, ask your doctor about current recommendations for ovarian cancer screening, including blood...
Read the Understanding Ovarian Cancer -- Prevention article > >
The serum CA 125 level is valuable in the follow-up and restaging of patients who have elevated CA 125 levels at the time of diagnosis.[2,3,4] While an elevated CA 125 level indicates a high probability of epithelial ovarian cancer, a negative CA 125 level cannot be used to exclude the presence of residual disease.[5] CA 125 levels can also be elevated in other malignancies and benign gynecologic problems such as endometriosis, and CA 125 levels should be used with a histologic diagnosis of epithelial ovarian cancer.[6,7]
The Féderation Internationale de Gynécologie et d'Obstétrique and the American Joint Committee on Cancer have designated staging .[8,9]
Stage I
Stage I ovarian cancer is limited to the ovaries.
- Stage IA: Tumor limited to one ovary; capsule intact, no tumor on ovarian surface. No malignant cells in ascites or peritoneal washings.*
- Stage IB: Tumor limited to both ovaries; capsules intact, no tumor on ovarian surface. No malignant cells in ascites or peritoneal washings.*
- Stage IC: Tumor limited to one or both ovaries with any of the following: capsule ruptured, tumor on ovarian surface, malignant cells in ascites or peritoneal washings.[8]
*The term, malignant ascites, is not classified. The presence of ascites does not affect staging unless malignant cells are present.
Stage II
Stage II ovarian cancer is
- Stage IIA: Extension and/or implants on the uterus and/or fallopian tubes. No malignant cells in ascites or peritoneal washings
- Stage IIB: Extension to and/or implants on other pelvic tissues. No malignant cells in ascites or peritoneal washings
- Stage IIC: Pelvic extension and/or implants (stage IIA or stage IIB) with malignant cells in ascites or peritoneal washings
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