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Table 1 Ovarian cancer staging (FIGO 2013 vs. FIGO 1988)

From: Adenocarcinoma of Mullerian origin: review of pathogenesis, molecular biology, and emerging treatment paradigms

FIGO (1988) FIGO (2013)
I: Tumor limited to the ovaries I: Tumor confined to ovaries or fallopian tube(s)a
IA: Tumor limited to 1 ovary (capsule intact), no tumor on ovarian surface, no malignant cells in ascites or peritoneal washings IA: Tumor limited to 1 ovary (capsule intact) or fallopian tube; no tumor on ovarian or fallopian tube surface; no malignant cells in the ascites or peritoneal washings
IB: Tumor limited to both ovaries (capsules intact), no tumor on ovarian surface, no malignant cells in ascites or peritoneal washings IB: Tumor limited to both ovaries (capsules intact) or fallopian tubes; no tumor on ovarian or fallopian tube surface; no malignant cells in the ascites or peritoneal washings
IC: Tumor limited to 1 or both ovaries with any of the following: capsule ruptured, tumor on ovarian surface, malignant cells in ascites or peritoneal washings IC: Tumor limited to 1 or both ovaries or fallopian tube(s) with any of the following:
IC1: Surgical spill intraoperatively
IC2: Capsule ruptured before surgery or tumor on ovarian or fallopian tube surface
IC3: Malignant cells in the ascites or peritoneal washings
II: Tumor involves 1 or both ovaries with pelvic extension II: Tumor involves 1 or both ovaries or fallopian tubes with pelvic extension (below pelvic brim) or primary peritoneal cancerb
IIA: Extension and/or implants on uterus and/or tube(s); no malignant cells in ascites or peritoneal washings IIA: Extension and/or implants on uterus and/or fallopian tubes and/or ovaries
IIB: Extension to other pelvic tissues; no malignant cells in ascites or peritoneal washings IIB: Extension to other pelvic intra-peritoneal tissues
IIC: Pelvic extension (IIA or IIB) with malignant cells in ascites or peritoneal washings  
III: Tumor involves 1 or both ovaries with microscopically confirmed peritoneal metastases outside the pelvis and/or regional lymph node metastasis III: Tumor involves 1 or both ovaries or fallopian tubes, or primary peritoneal cancer, with cytologically or histologically confirmed spread to the peritoneum outside the pelvis and/or metastasis to the retroperitoneal lymph nodes
IIIA: Microscopic peritoneal metastasis beyond pelvis IIIA1: Positive retroperitoneal lymph nodes only (cytologically or histologically proven)
IIIA1(i): Metastasis up to 10 mm in greatest dimension
IIIA1(ii): Metastasis more than 10 mm in greatest dimension
IIIA2: Microscopic extra-pelvic (above the pelvic brim) peritoneal involvement with or without positive retroperitoneal lymph nodes
IIIB: Macroscopic peritoneal metastasis beyond pelvis, 2 cm or less in greatest dimension IIIB: Macroscopic peritoneal metastasis beyond the pelvis up to 2 cm in greatest dimension, with or without metastasis to the retro-peritoneal lymph nodes (includes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ)
IIIC: Peritoneal metastasis beyond pelvis more than 2 cm in greatest dimension and/or regional lymph node metastasis IIIC: Macroscopic peritoneal metastasis beyond the pelvis more than 2 cm in greatest dimension, with or without metastasis to the retro-peritoneal lymph nodes (includes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ)
IV: Distant metastasis (excludes peritoneal metastasis) IV: Distant metastasis excluding peritoneal metastases
IVA: Pleural effusion with positive cytology
IVB: Parenchymal metastases and metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside of the abdominal cavity)c
  1. aIt is not possible to have stage I peritoneal cancer.
  2. bDense adhesions with histologically proven tumor cells justify upgrading apparent stage I tumors to stage II.
  3. cExtra-abdominal metastases include transmural bowel infiltration and umbilical deposits.
  4. Adapted from Zeppernick F, Meinhold-Heerlein I. The new FIGO staging system for ovarian, fallopian tube, and primary peritoneal cancer. Archives of gynecology and obstetrics. Aug 1 2014.