Ovarian cancer staging: Difference between revisions
Jump to navigation
Jump to search
Hudakarman (talk | contribs) |
|||
| (19 intermediate revisions by one other user not shown) | |||
| Line 1: | Line 1: | ||
{{CMG}} | __NOTOC__ | ||
{{Ovarian cancer}} | |||
{{CMG}}; {{AE}} {{Hudakarman}} | |||
{{Ovarian cancer}} | {{Ovarian cancer}} | ||
==Overview== | ==Overview== | ||
[[Ovarian cancer]] staging is by the International [[FIGO|Federation of Gynecology and Obstetrics]] ([[FIGO]]) [[Cancer staging|staging]] system and uses information obtained after [[surgery]], which can include a total [[abdominal]] [[hysterectomy]], removal of (usually) both [[ovaries]] and [[fallopian tubes]], (usually) the [[momentum]], and [[pelvic]] ([[peritoneal]]) washings for [[cytology]]. The [[American Joint Committee on Cancer]] ([[AJCC]]) [[Cancer staging|stage]] is the same as the [[FIGO]] stage. The [[Cancer staging|staging]] system is based on the [[surgical]] information about the [[tumor]], [[lymph nodes]], and [[metastasis]]. The evaluation of the [[tumor]] determines if it is primary or secondary, involve one [[ovary]], both [[ovaries]], or [[fallopian tube]], involve ovarian surface, capsule rupture, and if there is dense [[adhesions]]. | |||
==Staging== | ==Staging== | ||
* [[Ovarian cancer]] staging is by the [[FIGO]] staging system and uses information obtained after surgery, which can include a total abdominal [[hysterectomy]], removal of (usually) both ovaries and fallopian tubes, (usually) the [[ | * [[Ovarian cancer]] [[Cancer staging|staging]] is by the [[International Federation of Gynecology and Obstetrics]] ([[FIGO]]) [[Cancer staging|staging]] system and uses information obtained after [[surgery]], which can include a total abdominal [[hysterectomy]], removal of (usually) both [[ovaries]] and [[fallopian tubes]], (usually) the [[momentum]], and [[pelvic]] ([[peritoneal]]) washings for [[cytology]]. The [[American Joint Committee on Cancer]] ([[AJCC]]) stage is the same as the [[FIGO]] stage.<ref name="pmid24219974">{{cite journal| author=Prat J, FIGO Committee on Gynecologic Oncology| title=Staging classification for cancer of the ovary, fallopian tube, and peritoneum. | journal=Int J Gynaecol Obstet | year= 2014 | volume= 124 | issue= 1 | pages= 1-5 | pmid=24219974 | doi=10.1016/j.ijgo.2013.10.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24219974 }}</ref> | ||
* The staging system is the same for ovarian, fallopian tube, and peritoneal carcinoma with large variations based on the histologic subtypes | *The [[Cancer staging|staging]] system is based on the surgical information about the [[tumor]], [[lymph nodes]], and [[metastasis]]. | ||
*To achieve better outcome, the surgical staging procedure should be operated by gynecologist oncologist. | *The following should be considered when evaluating the [[tumor]]: | ||
** Is it primary or secondary | |||
** Involvement of both [[ovaries]] or [[ovarian tube]] | |||
** Involvement of [[ovarian]] surface and hence, expose [[peritoneum]] to the tumor cells | |||
** Rupture of the capsule | |||
** Presence of dense [[adhesions]] | |||
* The [[Cancer staging|staging]] system is the same for [[ovarian cancer]], [[fallopian tube cancer]], and [[Peritoneal carcinomatosis|peritoneal carcinoma]] with large variations based on the [[histologic]] subtypes | |||
*To achieve better outcome, the [[surgical]] staging procedure should be operated by [[Gynecologic oncology|gynecologist oncologist]]. | |||
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | |||
{| | ! style="background: #4479BA; padding: 5px 5px;" rowspan=1 | {{fontcolor|#FFFFFF| Stage}} | ||
! style="background: #4479BA; padding: 5px 5px;" rowspan=1 | {{fontcolor|#FFFFFF| Definition}} | |||
|- | |- | ||
| I||Tumor confined to ovaries or fallopian tubes | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[I]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Tumor confined to [[ovaries]] or [[fallopian tubes]] | |||
|- | |- | ||
| IA||Tumor limited to one ovary (capsule intact) or fallopian tube; | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IA]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Tumor limited to one [[ovary]] (capsule intact) or [[fallopian tube]] | |||
*No tumor on ovarian or fallopian tube surface | |||
*No [[malignant]] cells in the [[ascites]] or [[Peritoneal|peritoneal washings]] | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IB]]''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Tumor limited to both [[ovaries]] (capsules intact) or [[fallopian tubes]] | |||
*No tumor on [[ovarian]] or [[Fallopian tube|fallopian tube surface]] | |||
*No [[malignant]] cells in the [[ascites]] or [[peritoneal]] washings | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Tumor]] limited to one or both [[ovaries]] or [[fallopian tube]]<nowiki/>s, with any of the following: | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC1]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Surgical spill intraoperatively | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC2]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Capsule ruptured before surgery or tumor on [[ovarian]] or [[fallopian tube]] surface | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC3]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Malignant]] cells present in the [[ascites]] or [[peritoneal]] washings | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[II]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Tumor involves one or both [[ovaries]] or [[fallopian tubes]] with [[pelvic]] extension (below [[pelvic brim]]) or [[Peritoneal carcinomatosis|peritoneal cancer]] | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIA]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Extension and/or [[implants]] on the [[uterus]] and/or [[fallopian tubes]] and/or [[ovaries]] | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIB]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Extension to other [[pelvic]] [[intraperitoneal]] tissues | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[III]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Tumor involves one or both [[ovaries]], or [[fallopian tubes]] | |||
*Or [[primary peritoneal cancer]], with [[Cytological|cytologically]] or [[histologically]] confirmed spread to the [[peritoneum]] outside of the [[pelvis]] | |||
*And/or [[metastasis]] to the [[retroperitoneal]] [[lymph nodes]] | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Metastasis]] to the [[retroperitoneal]] [[lymph nodes]] with or without microscopic [[peritoneal]] involvement beyond the [[pelvis]] | |||
|- | |- | ||
| IIIA|| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA(i)]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Positive [[retroperitoneal]] [[lymph nodes]] only ([[Cytological|cytologically]] or [[histologically]] proven) | |||
|- | |- | ||
| IIIA( | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA(ii)]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Metastasis]] >10 mm in greatest dimension | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA2]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Microscopic]] extrapelvic (above the [[pelvic brim]]) [[peritoneal]] involvement with or without positive [[retroperitoneal]] [[lymph nodes]] | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIB]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Macroscopic]] [[peritoneal]] [[metastases]] beyond the [[pelvic brim]] ≤ 2 cm in greatest dimension, with or without [[metastasis]] to the [[retroperitoneal]] [[lymph nodes]] | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIC]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Macroscopic]] [[peritoneal]] [[metastases]] beyond the [[pelvic brim]] >2 cm in greatest dimension, with or without [[metastases]] to the [[retroperitoneal]] [[lymph nodes]] | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IV]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Distant [[metastasis]] excluding [[peritoneal]] [[metastases]] | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IVA]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Pleural effusion]] with positive [[cytology]] | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IVB]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*[[Metastases]] to extra-[[abdominal organs]] (including [[inguinal lymph nodes]] and [[lymph nodes]] outside of the [[abdominal cavity]]) | |||
|- | |- | ||
|} | |} | ||
Latest revision as of 18:50, 12 September 2019
|
Ovarian cancer Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Ovarian cancer staging On the Web |
|
American Roentgen Ray Society Images of Ovarian cancer staging |
|
Risk calculators and risk factors for Ovarian cancer staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.
|
Ovarian cancer Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Ovarian cancer staging On the Web |
|
American Roentgen Ray Society Images of Ovarian cancer staging |
|
Risk calculators and risk factors for Ovarian cancer staging |
Overview
Ovarian cancer staging is by the International Federation of Gynecology and Obstetrics (FIGO) staging system and uses information obtained after surgery, which can include a total abdominal hysterectomy, removal of (usually) both ovaries and fallopian tubes, (usually) the momentum, and pelvic (peritoneal) washings for cytology. The American Joint Committee on Cancer (AJCC) stage is the same as the FIGO stage. The staging system is based on the surgical information about the tumor, lymph nodes, and metastasis. The evaluation of the tumor determines if it is primary or secondary, involve one ovary, both ovaries, or fallopian tube, involve ovarian surface, capsule rupture, and if there is dense adhesions.
Staging
- Ovarian cancer staging is by the International Federation of Gynecology and Obstetrics (FIGO) staging system and uses information obtained after surgery, which can include a total abdominal hysterectomy, removal of (usually) both ovaries and fallopian tubes, (usually) the momentum, and pelvic (peritoneal) washings for cytology. The American Joint Committee on Cancer (AJCC) stage is the same as the FIGO stage.[1]
- The staging system is based on the surgical information about the tumor, lymph nodes, and metastasis.
- The following should be considered when evaluating the tumor:
- Is it primary or secondary
- Involvement of both ovaries or ovarian tube
- Involvement of ovarian surface and hence, expose peritoneum to the tumor cells
- Rupture of the capsule
- Presence of dense adhesions
- The staging system is the same for ovarian cancer, fallopian tube cancer, and peritoneal carcinoma with large variations based on the histologic subtypes
- To achieve better outcome, the surgical staging procedure should be operated by gynecologist oncologist.
| Stage | Definition |
|---|---|
| I |
|
| IA |
|
| IB |
|
| IC |
|
| IC1 |
|
| IC2 |
|
| IC3 |
|
| II |
|
| IIA |
|
| IIB |
|
| III |
|
| IIIA |
|
| IIIA(i) |
|
| IIIA(ii) |
|
| IIIA2 |
|
| IIIB |
|
| IIIC |
|
| IV |
|
| IVA |
|
| IVB |
|
References
- ↑ Prat J, FIGO Committee on Gynecologic Oncology (2014). "Staging classification for cancer of the ovary, fallopian tube, and peritoneum". Int J Gynaecol Obstet. 124 (1): 1–5. doi:10.1016/j.ijgo.2013.10.001. PMID 24219974.