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We explain the different ovarian cancer stages and grades.

When you receive an ovarian cancer diagnosis, the medical team aims to identify:

Stages

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

The tumour is confined to the ovaries or fallopian tubes.

Stage 1A

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.

Stage 1B

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.

Stage 1C

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).

Stage 2A

The cancer is also affecting the uterus and/or fallopian tubes. However cancerous cells are not detected in the fluid taken from the abdomen.

Stage 2B

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. 

Stage 3A

Very tiny cancer cells are detected in in the lymph nodes in the lining of the abdomen.

Stage 3A2

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.

Stage 3B

Small tumours (less than 2cm in diameter) are detectable beyond the pelvis, and the lymph nodes may or may not contain cancerous cells.

Stage 3C

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

The cancer cells have spread to another organ such as the liver, the brain or the lungs

Grades

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.

Grade 2

'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.

The information on this page is approved by the Information Standard scheme to ensure that it provides accurate and high-quality information.
Last reviewed: February 2013
Next Review: currently under review