Ovarian Cancer Staging

Ovarian / Fallopian / Peritoneal

FIGO 2014 Revised Staging

Confined to Ovaries/Tubes

IA (1 side) | IB (Both sides) | IC (Capsule rupture/Washings +ve)

Pelvic Extension

IIA (Uterus/Tubes/Ovaries) | IIB (Other pelvic tissues)

III

Extra-Pelvic Peritoneal / Nodes

IIIA (Retroperitoneal nodes) | IIIB (Microscopic peritoneal) | IIIC (Macroscopic >2cm)

Distant Metastasis

IVA (Pleural effusion +ve cytology) | IVB (Parenchymal metastasis)

Surgical staging is mandatory for ovarian cancer including omentectomy and lymphadenectomy.

Guidelines & Evidence

Verified

Last Review: 2026-07-17

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.

How it Works

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)
IIIA2	Microscopic extrapelvic peritoneal involvement (above brim)
IIIB	Macroscopic peritoneal metastasis ≤ 2 cm
IIIC	Macroscopic peritoneal metastasis > 2 cm (includes capsule of liver/spleen)

Stage IV — Distant Metastasis

IVA	Pleural effusion with positive cytology
IVB	Hepatic and/or splenic parenchymal mets, or extra-abdominal origins

Last Comprehensive Review: 2026-07-17

In Recent Clinical News

Scanning Medical Journals

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Ovarian Cancer Staging

Ovarian / Fallopian / Peritoneal

When to Use

Primary Clinical Uses

The Fallopian Paradigm

How it Works

Stage I — Confined to Ovaries/Tubes

Stage II — Pelvic Extension (below pelvic brim)

Stage III — Peritoneal/Nodal Spread

Stage IV — Distant Metastasis

Clinical Pearls

Surgical Spillage Alert

Next Steps

Adjuvant Chemotherapy Triggers

The Evidence

The 2014 Unification

FIGO 2014 Ovarian cancer staging update.

Origins & History

A Modern Understanding

In Recent Clinical News

Ovarian Cancer Staging

Ovarian / Fallopian / Peritoneal

When to Use

Primary Clinical Uses

The Fallopian Paradigm

How it Works

Stage I — Confined to Ovaries/Tubes

Stage II — Pelvic Extension (below pelvic brim)

Stage III — Peritoneal/Nodal Spread

Stage IV — Distant Metastasis

Clinical Pearls

Surgical Spillage Alert

Next Steps

Adjuvant Chemotherapy Triggers

The Evidence

The 2014 Unification

FIGO 2014 Ovarian cancer staging update.

Origins & History

A Modern Understanding

In Recent Clinical News