Surgical staging is mandatory for ovarian cancer including omentectomy and lymphadenectomy.
Guidelines & Evidence
Clinical Details
Section 1
When to Use
Primary Clinical Uses
Surgical staging of primary carcinoma of the ovary, fallopian tube, and peritoneum
Predicting overall survival and recurrence risk
Determining the obligite need for adjuvant platinum-based chemotherapy
The Fallopian Paradigm
The 2014 FIGO update unified Ovarian, Fallopian Tube, and Primary Peritoneal cancers under one identical staging classification. This reflects the modern oncological consensus that high-grade serous "ovarian" carcinoma predominantly originates in the fimbriated end of the fallopian tube.
Section 2
Formula & Logic
Stage I — Confined to Ovaries/Tubes
IA
One ovary involved, capsule intact. No tumor on surface.
IB
Both ovaries involved, capsules intact. No tumor on surface.
IC1
Surgical spill (iatrogenic during operation)
IC2
Capsule ruptured before surgery OR tumor on surface
IC3
Malignant cells in ascites or peritoneal washings
Stage II — Pelvic Extension (below pelvic brim)
IIA
Extension tracking to the uterus or fallopian tubes
IIB
Extension to other pelvic intraperitoneal tissues (e.g., rectum/bladder serosa)
Stage III — Peritoneal/Nodal Spread
IIIA1
Positive retroperitoneal lymph nodes ONLY (i-microscopic, ii-macro >2mm)
Stage IC and above: Universal requirement for adjuvant chemotherapy (typically 6 cycles Carboplatin + Paclitaxel).
04
Stage III/IV: Evaluate for primary cytoreductive surgery versus neoadjuvant chemotherapy initially, followed by interval debulking.
Section 5
Evidence Appraisal
The 2014 Unification
FIGO 2014 Ovarian cancer staging update.
Berek JS et al. • Int J Gynaecol Obstet.. 2014;Formally merged the tubal, peritoneal, and ovarian cancers into a unified schema and subdivided Stage III nodal disease.
Section 6
Literature
A Modern Understanding
The fundamental recognition by pathologists like Dr. Robert Kurman that pelvic serous cancers originate in the fallopian tube epithelium (STIC lesions) drove FIGO to entirely restructure how these diseases are tracked.
