We explain the different ovarian cancer stages and grades.
When you receive an ovarian cancer diagnosis, the medical team aims to identify:
- the type and subtype of ovarian cancer
- the stage of the ovarian cancer (how far it has spread)
- the grade of the ovarian cancer
An international system of staging is used, which looks at how the ovarian cancer has spread. This involves taking numerous samples and examining you during surgery.
It is an important part of the diagnosis because it can influence your treatment options, and is likely to be carried out by a specialist.
The staging system is called the FIGO system, after its authors - the International Federation of Gynaecological Oncologists.
FIGO staging system
Stage 1 ovarian cancer
This means only one ovary or fallopian tube is affected by the tumour, and the ovary is intact. No cancer is detected on the surface of the ovary or fallopian tube and there are no malignant (cancerous) cells detected in fluid taken from the abdomen.
Both ovaries, or fallopian tubes, are affected by the tumour, but both ovaries are intact. No cancer is detected in either the surface of the ovaries or fallopian tube, or in the fluid from the abdomen.
One or both ovaries, or fallopian tubes, are affected. However there is also any of the following:
- A detectable tumour on the ovary or fallopian tube surface.
- The ovary capsule is ruptured (no longer intact) before surgery, or as a result of the surgery.
- Cancerous cells are detected in the fluid taken from the abdomen.
Stage 2 ovarian cancer
The tumour is in one or both ovaries, or fallopian tubes, and has extended into the pelvis or the peritoneum (thin flexible sheet of transparent tissue that covers the organs inside your abdomen).
The cancer is also affecting the uterus and/or fallopian tubes. However cancerous cells are not detected in the fluid taken from the abdomen.
The cancer is affecting other organs in your pelvis, but cancerous cells are not detectable in the fluid taken from the abdomen.
Stage 3 ovarian cancer
The tumour is in one or both ovaries, or fallopian tubes, or the peritoneum, and has also extended to the lining of the pelvis and abdomen and/or nearby lymph nodes.
Very tiny cancer cells are detected in in the lymph nodes in the lining of the abdomen.
Very tiny cancer cells are detected above the pelvis, with or without the tumour detectable in the lymph nodes in the lining of the abdomen.
Small tumours (less than 2cm in diameter) are detectable beyond the pelvis, and the lymph nodes may or may not contain cancerous cells.
Small tumours (less than 2cm in diameter) are detected beyond the pelvis, including into the non-functional part of the liver and spleen and/or there is cancer detected in the lymph nodes.
Stage 4 ovarian cancer – A and B
Grading can help predict how the cancer will behave, including how likely it is to spread, which may impact on treatments and follow up.
It is split into four categories:
Grade 0 - Borderline or low malignancy potential
This means that spread is very unlikely.
Grade 1 - Low grade tumours
Often described as 'well differentiated'. This means the cells look very similar to normal cells, and are not as likely as high grade tumours to spread.
'Moderately differentiated' tumours are in between low and high grade.
Grade 3 - High grade tumours
Described as 'poorly differentiated'. These have a tendency to grow and spread more quickly than low grade tumours.
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Last reviewed: February 2013
Next Review: Currently under review