Stages of childhood ovarian cancer
Cancer stage describes the extent of cancer in the body, such as the size of the tumor, whether it has spread, and how far it has spread from where it first formed. It is important to know the stage of ovarian cancer to plan the best treatment.
There are several different staging systems for cancer. The International Federation of Gynecology and Obstetrics (FIGO) staging system is used for ovarian cancer. Based on the FIGO results, a stage is assigned to your child's ovarian cancer, such as stage I, stage II, stage III, or stage IV (may also be written as stage 1, stage 2, stage 3, or stage 4). When talking with you about your child's cancer, your child's doctor may describe it as one of these stages.
Stage I (also called stage 1) ovarian cancer
In stage IA, cancer is found inside a single ovary or fallopian tube. In stage IB, cancer is found inside both ovaries or fallopian tubes. In stage IC, cancer is found inside one or both ovaries or fallopian tubes and one of the following is true: (a) either the tumor or the capsule (outer covering) of the ovary has ruptured (broken open), or (b) cancer is also found on the surface of the ovary or fallopian tube, or (c) cancer cells are found in the pelvic peritoneal fluid.
In stage I, ovarian cancer has formed and is found in one or both ovaries or fallopian tubes. Stage I is divided into stages IA, IB, and IC.
- Stage IA: Cancer is found inside a single ovary or fallopian tube.
- Stage IB: Cancer is found inside both ovaries or fallopian tubes.
- Stage IC: Cancer is found inside one or both ovaries or fallopian tubes. Stage IC is further divided based on whether the cancer is found outside the ovary.
- Stage IC1: The tumor ruptured (broke open) during surgery.
- Stage IC2: The capsule (outer covering) of the ovary ruptured before surgery, or there is cancer on the surface of the ovary or fallopian tube.
- Stage IC3: Cancer cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal cavity).
Stage II (also called stage 2) ovarian cancer
In stage IIA, cancer is found in one or both ovaries or fallopian tubes and has spread to the uterus and/or the fallopian tubes and/or the ovaries. In stage IIB, cancer is found in one or both ovaries or fallopian tubes and has spread to organs in the peritoneal cavity, such as the colon. In primary peritoneal cancer, cancer is found in the pelvic peritoneum and has not spread there from another part of the body.
In stage II, cancer is found in one or both ovaries or fallopian tubes and has spread into other areas of the pelvis, or primary peritoneal cancer is found within the pelvis.
Stage II is subdivided based on whether the cancer has spread to other tissue.
- Stage IIA: The cancer has spread from where it first formed to the uterus and/or the fallopian tubes and/or the ovaries.
- Stage IIB: The cancer has spread from the ovary or fallopian tube to organs in the peritoneal cavity (the body cavity that contains most of the organs in the abdomen).
Stage III (also called stage 3) ovarian cancer
Tumor sizes are often measured in centimeters (cm) or inches. Common food items that can be used to show tumor size in cm include: a pea (1 cm), a peanut (2 cm), a grape (3 cm), a walnut (4 cm), a lime (5 cm or 2 inches), an egg (6 cm), a peach (7 cm), and a grapefruit (10 cm or 4 inches).
In stage III, cancer is found in one or both ovaries or fallopian tubes, or is primary peritoneal cancer, and has spread outside the pelvis to other parts of the abdomen and/or to nearby lymph nodes.
Stage III is subdivided based on how far the cancer has spread.
- Stage IIIA1: The cancer has spread to lymph nodes behind the peritoneum only.
- Stage IIIA2: The cancer cells that can be seen only with a microscope have spread to the surface of the peritoneum outside the pelvis, such as the omentum (a fold of the peritoneum that surrounds the stomach and other organs in the abdomen). Cancer may have spread to nearby lymph nodes.
In stage IIIA, cancer is found in one or both ovaries or fallopian tubes and (a) cancer has spread to lymph nodes behind the peritoneum only, or (b) cancer cells that can be seen only with a microscope have spread to the surface of the peritoneum outside the pelvis, such as the omentum. Cancer may have also spread to nearby lymph nodes.
- Stage IIIB: The cancer has spread to the peritoneum outside the pelvis, such as the omentum, and the cancer in the peritoneum is 2 centimeters or smaller. Cancer may have spread to lymph nodes behind the peritoneum.
In stage IIIB, cancer is found in one or both ovaries or fallopian tubes and has spread to the peritoneum outside the pelvis, such as the omentum. The cancer in the omentum is 2 centimeters or smaller. Cancer may have also spread to lymph nodes behind the peritoneum.
- Stage IIIC: The cancer has spread to the peritoneum outside the pelvis, such as the omentum, and the cancer in the peritoneum is larger than 2 centimeters. Cancer may have spread to lymph nodes behind the peritoneum or to the surface of the liver or spleen.
In stage IIIC, cancer is found in one or both ovaries or fallopian tubes and has spread to the peritoneum outside the pelvis, such as the omentum. The cancer in the omentum is larger than 2 centimeters. Cancer may have also spread to lymph nodes behind the peritoneum or to the surface of the liver or spleen (not shown).
Stage IV (also called stage 4) ovarian cancer
In stage IV, cancer has spread beyond the abdomen to other parts of the body. In stage IVA, cancer cells are found in extra fluid that builds up around the lungs. In stage IVB, cancer has spread to organs and tissues outside the abdomen, including the lung, liver, and lymph nodes in the groin.
In stage IV, cancer has spread beyond the abdomen to other parts of the body. Stage IV is divided into stage IVA and stage IVB.
- Stage IVA: Cancer cells are found in extra fluid that builds up around the lungs.
- Stage IVB: Cancer has spread to organs and tissues outside the abdomen, including lymph nodes in the groin.
Stage IV ovarian cancer is also called metastatic ovarian cancer. Metastatic cancer happens when cancer cells travel through the lymphatic system or blood and form tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if ovarian cancer spreads to the lung, the cancer cells in the lung are actually ovarian cancer cells. The disease is called metastatic ovarian cancer, not lung cancer. Learn more in Metastatic Cancer: When Cancer Spreads.
Recurrent ovarian cancer
Recurrent ovarian cancer is cancer that has come back after it has been treated. The cancer may come back in the ovary or as metastatic tumors in other parts of the body. Tests will be done to help determine where the cancer has returned in the body, if it has spread, and how far. The type of treatment that your child will have for recurrent ovarian cancer will depend on how far it has spread.
To learn more, see Recurrent Cancer: When Cancer Comes Back.