FIGO Stage Classification for Ovarian Cancer

The 2013 International Federation of Obstetricians and Gynaecologists (FIGO) Staging System for Ovarian Cancer

An international system of staging is used, and identifies the spread of the ovarian cancer at the point of diagnosis. It is important to receive correct staging as this can impact on treatment decisions. The staging system is called the FIGO system, after its authors - the International Federation of Gynaecological Oncologists. 

STAGE 1 Tumour is confined to the ovary / ovaries or fallopian tube(s)

 1A

- Only one ovary or fallopian tube is affected by the tumour, the ovary capsule is intact
- No tumour is detected on the surface of the ovary or fallopian tube
- Malignant cells are not detected in ascites or peritoneal washings

 1B

- Both ovaries or fallopian tubes are affected by the tumour, the ovary capsule is intact
- No tumour is detected on the surface of the ovaries or fallopian tube
- Malignant cells are not detected in ascites or peritoneal washings

 1C

The tumour is limited to one or both ovaries or fallopian tubes, with any of the following:
- Surgical spill
- The ovary capsule is ruptured before surgery
- The tumour is detected on the ovary or fallopian tube surface
- Malignant cells are detected in the ascites or peritoneal washings

STAGE 2 Tumour involves one or both ovaries or fallopian tubes with pelvic extension (below pelvic brim) or primary peritoneal cancer

 2A

- The tumour has extended and/or implanted into the uterus and/or the fallopian tubes and/or ovaries

 2B

- The tumour has extended to another organ in the pelvis

STAGE 3 The tumour involves one or both ovaries or fallopian tubes, or primary peritoneal cancer, with confirmed (cytologically or histologically) spread to the peritoneal surfaces involving both pelvic and abdominal peritoneum and/or metastasis to the retroperitoneal lymph nodes

 3A1

Positive retroperitoneal lymph nodes only (cytologically or histologically proven)
- Metastasis up to 10mm in greatest dimension
- Metastasis more than 10mm in greatest dimension

 3A2

- Microscopic extrapelvic peritoneal involvement with or without positive retroperitoneal lymph nodes

 3B

- Microscopic peritoneal metastasis beyond the pelvis 2 cm in greatest dimension, with or without metastasis to the retro-peritoneal lymph nodes

 3C

- Microscopic peritoneal metastasis beyond the pelvis 2 cm in greatest dimension, with or without metastasis to the retro-peritoneal lymph nodes (includes extension of tumour to capsule of liver and spleen without parenchymal involvement of either organ)

STAGE 4 Distant metastasis beyond the peritoneal cavity (including parenchymal liver/splenic metastases and extra-abdominal metastases

 4A

- Pleural effusion with positive cytology

 4B

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

 Please note: This replaces the FIGO (1988) ovarian cancer staging system