Ovarian cancer staging: Difference between revisions
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{{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 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 [[ | * [[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 based on the surgical information about the tumor, lymph nodes, and metastasis. | *The [[Cancer staging|staging]] system is based on the surgical information about the [[tumor]], [[lymph nodes]], and [[metastasis]]. | ||
*The following should be considered when evaluating the tumor: | *The following should be considered when evaluating the [[tumor]]: | ||
** Is it primary or secondary | ** Is it primary or secondary | ||
** Involvement of both ovaries or ovarian tube | ** Involvement of both [[ovaries]] or [[ovarian tube]] | ||
** Involvement of ovarian surface and hence, expose peritoneum to the tumor cells | ** Involvement of [[ovarian]] surface and hence, expose [[peritoneum]] to the tumor cells | ||
** Rupture of the capsule | ** Rupture of the capsule | ||
** Presence of dense adhesions | ** Presence of dense [[adhesions]] | ||
* 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 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 gynecologist oncologist. | *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="border: 0px; font-size: 90%; margin: 3px;" align="center" | ||
Line 23: | Line 28: | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[I]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[I]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Tumor confined to ovaries or fallopian tubes | *Tumor confined to [[ovaries]] or [[fallopian tubes]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IA]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IA]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Tumor limited to one ovary (capsule intact) or fallopian tube | *Tumor limited to one [[ovary]] (capsule intact) or [[fallopian tube]] | ||
*No tumor on ovarian or fallopian tube surface | *No tumor on ovarian or fallopian tube surface | ||
*No malignant cells in the ascites or peritoneal washings | *No [[malignant]] cells in the [[ascites]] or [[Peritoneal|peritoneal washings]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IB]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IB]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Tumor limited to both ovaries (capsules intact) or fallopian tubes | *Tumor limited to both [[ovaries]] (capsules intact) or [[fallopian tubes]] | ||
*No tumor on ovarian or fallopian tube surface | *No tumor on [[ovarian]] or [[Fallopian tube|fallopian tube surface]] | ||
*No malignant cells in the ascites or peritoneal washings | *No [[malignant]] cells in the [[ascites]] or [[peritoneal]] washings | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Tumor limited to one or both ovaries or fallopian | *[[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: #DCDCDC;" | '''[[IC1]]''' | ||
Line 47: | Line 52: | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC2]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC2]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Capsule ruptured before surgery or tumor on ovarian or fallopian tube surface | *Capsule ruptured before surgery or tumor on [[ovarian]] or [[fallopian tube]] surface | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC3]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IC3]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Malignant cells present in the ascites or peritoneal washings | *[[Malignant]] cells present in the [[ascites]] or [[peritoneal]] washings | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[II]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[II]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Tumor involves one or both ovaries or fallopian tubes with pelvic extension (below pelvic brim) or peritoneal cancer | *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: #DCDCDC;" | '''[[IIA]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Extension and/or implants on the uterus and/or fallopian tubes and/or ovaries | *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: #DCDCDC;" | '''[[IIB]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Extension to other pelvic intraperitoneal tissues | *Extension to other [[pelvic]] [[intraperitoneal]] tissues | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[III]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[III]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Tumor involves one or both ovaries, or fallopian tubes | *Tumor involves one or both [[ovaries]], or [[fallopian tubes]] | ||
*Or primary peritoneal cancer, with cytologically or histologically confirmed spread to the peritoneum outside of the pelvis | *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 | *And/or [[metastasis]] to the [[retroperitoneal]] [[lymph nodes]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Metastasis to the retroperitoneal lymph nodes with or without microscopic peritoneal involvement beyond the pelvis | *[[Metastasis]] to the [[retroperitoneal]] [[lymph nodes]] with or without microscopic [[peritoneal]] involvement beyond the [[pelvis]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA(i)]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA(i)]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Positive retroperitoneal lymph nodes only (cytologically or histologically proven) | *Positive [[retroperitoneal]] [[lymph nodes]] only ([[Cytological|cytologically]] or [[histologically]] proven) | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA(ii)]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA(ii)]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Metastasis >10 mm in greatest dimension | *[[Metastasis]] >10 mm in greatest dimension | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA2]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IIIA2]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Microscopic extrapelvic (above the pelvic brim) peritoneal involvement with or without positive retroperitoneal lymph nodes | *[[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: #DCDCDC;" | '''[[IIIB]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Macroscopic peritoneal metastases beyond the pelvic brim | *[[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: #DCDCDC;" | '''[[IIIC]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | 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 nodes | *[[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: #DCDCDC;" | '''[[IV]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Distant metastasis excluding peritoneal metastases | *Distant [[metastasis]] excluding [[peritoneal]] [[metastases]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IVA]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IVA]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Pleural effusion with positive cytology | *[[Pleural effusion]] with positive [[cytology]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" | '''[[IVB]]''' | | style="padding: 5px 5px; background: #DCDCDC;" | '''[[IVB]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside of the abdominal cavity) | *[[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.