Stage I

Stage I ovarian cancer is limited to the ovaries.

Stage IA: Tumor limited to one ovary; capsule intact, no tumour on ovarian surface. No malignant cells in ascites or peritoneal washings.* Stage IB: Tumor limited to both ovaries; capsules intact, no tumour on ovarian surface. No malignant cells in ascites or peritoneal washings.* Stage IC: Tumor limited to one or both ovaries with any of the following: capsule ruptured, tumour on ovarian surface, malignant cells in ascites or peritoneal washings.[8]

* [Note: The term, malignant ascites, is not classified. The presence of ascites does not affect staging unless malignant cells are present.]

Stage II

Stage II ovarian cancer is tumour involving one or both ovaries with pelvic extension and/or implants

Stage IIA: Extension and/or implants on the uterus and/or fallopian tubes. No malignant cells in ascites or peritoneal washings. Stage IIB: Extension to and/or implants on other pelvic tissues. No malignant cells in ascites or peritoneal washings. Stage IIC: Pelvic extension and/or implants (stage IIA or stage IIB) with malignant cells in ascites or peritoneal washings.

Different criteria for allotting cases to stage IC and stage IIC have an impact on diagnosis. To assess this impact, of value would be to know if rupture of the capsule was (1) spontaneous or (2) caused by the surgeon; and, if the source of malignant cells detected was (1) peritoneal washings or (2) ascites

Stage III

Stage III ovarian cancer is tumour involving one or both ovaries with microscopically confirmed peritoneal implants outside the pelvis. Superficial liver metastasis equals stage III. Tumor is limited to the true pelvis but with histologically verified malignant extension to small bowel or omentum

Stage IIIA: Microscopic peritoneal metastasis beyond pelvis (no macroscopic tumour). Stage IIIB: Macroscopic peritoneal metastasis beyond pelvis 2 cm or less in greatest dimension. Stage IIIC: Peritoneal metastasis beyond pelvis more than 2 cm in greatest dimension and/or regional lymph node metastasis.

Stage IV

Stage IV ovarian cancer is tumour involving one or both ovaries with distant metastasis. If pleural effusion is present, positive cytologic test results must exist to designate a case to stage IV. Parenchymal liver metastasis equals stage IV (Shepherd 1989).