FIGO Surgical Staging of Ovarian, Fallopian Tube, and Peritoneal Cancer

Stage

Description

I

Tumor limited to the ovaries or fallopian tubes

  1. IA

Tumor limited to one ovary (capsule intact) or fallopian tube; no tumor on ovarian or fallopian tube surface; no malignant cells in ascitic fluid or in peritoneal washings

  1. IB

Tumor limited to one or both ovaries (capsule intact) or fallopian tubes; no tumor on the surface of ovary or fallopian tube; no malignant cells in ascitic fluid or in peritoneal washings

  1. IC

Tumor limited to one or both ovaries or fallopian tubes, plus any of the following:

  1. IC1

  • Surgical spill

  1. IC2

  • Capsule ruptured before surgery or tumor on the surface of the ovary or fallopian tube

  1. IC3

  • Malignant cells in ascitic fluid or in peritoneal washings

II

Tumor involving one or both ovaries or fallopian tubes with pelvic extension (below pelvic brim) or peritoneal cancer

  1. IIA

Extension and/or implants on the uterus, fallopian tubes, and/or ovaries

  1. IIB

Extension and/or implants on other pelvic intraperitoneal tissues

III

Tumor involving one or both ovaries or fallopian tubes or peritoneal cancer with microscopically confirmed peritoneal metastases outside the pelvis and/or metastasis to the retroperitoneal lymph nodes

  1. IIIA1

Positive retroperitoneal lymph nodes only (histologically proved)

  1. IIIA1(i)

Metastasis ≤ 10 mm in largest dimension

  1. IIIA1(ii)

Metastasis > 10 mm in largest dimension

  1. IIIA2

Microscopic extrapelvic (beyond the pelvic brim) peritoneal involvement, with or without positive retroperitoneal lymph nodes

  1. IIIB

Macroscopic peritoneal metastases that extend beyond the pelvis and that are 2 cm in largest dimension, with or without positive retroperitoneal lymph nodes

IIIC

Macroscopic peritoneal metastases that extend beyond the pelvis and are > 2 cm in largest dimension, with or without metastasis to retroperitoneal lymph nodes (includes extension of tumor to the capsule of the liver and spleen without parenchymal involvement of either organ)

IV

Distant metastases excluding peritoneal metastases

  1. IVA

Pleural effusion with positive cytology

  1. IVB

Parenchymal metastasis and/or metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity)

Adapted from staging established by the International Federation of Gynecology and Obstetrics (FIGO): Berek JS, Renz M, Kehoe S,et al: Cancer of the ovary, fallopian tube, and peritoneum: 2021 update. Int J Gynaecol Obstet 155 Suppl 1:61–85, 2021. doi: 10.1002/ijgo.13878