Staging and prognosis for ovarian cancer

The diagnostic tests help show whether you have ovarian cancer and whether it has spread to other parts of the body. This process is called staging and it helps your health care team recommend the best treatment for you.

In most instances, your doctor will not have enough information to work out the stage of the ovarian cancer until after surgery.

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Staging ovarian cancer

The staging system most commonly used for ovarian cancer is the International Federation of Gynecology and Obstetrics (FIGO) system. It divides ovarian cancer into four stages. Each stage is further divided into sub-stages, such as A, B, C, which indicate increasing amounts of tumour.

Stages I–II mean that it is early ovarian cancer. Stages III–IV mean the cancer is advanced. About 7 out of 10 women with ovarian cancer are diagnosed at stages III or IV.

Stages of ovarian cancer (FIGO system)

Stage I

Cancer is in one or both ovaries only.

Stage II

Cancer is in one or both ovaries and has spread to other organs in the pelvis (uterus, fallopian tubes, bladder or bowel).

Stage III

Cancer is in one or both ovaries and has spread beyond the pelvis to the lining of the abdomen (peritoneum) or to nearby lymph nodes.

Stage IV

The cancer has spread further to distant organs such as the lung or liver.


Grading ovarian cancer

Grading describes how the cancer cells look compared to normal cells. It helps work out how aggressive the cancer cells may be. Treatment has a greater chance of success if the grade is lower.

Grade 1

The cancer cells look similar to normal cells and are probably growing relatively slowly.

Grade 2

The cancer cells appear slightly abnormal and might grow more rapidly.

Grade 3

The cancer cells look very different from normal cells and may grow quickly.


Prognosis

Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for any doctor to predict the exact course of the disease in an individual person.

Epithelial cancer – The stage and grade of the cancer will influence the outcome. If epithelial ovarian cancer is diagnosed and treated before the cancer has spread outside the ovary (stage I), it has a good prognosis. Many women with more advanced cancer may respond well to treatment, but the cancer often comes back (recurs) and further treatment is needed.

Germ cell and stromal cell tumours – These can usually be treated successfully.

Borderline tumour – This usually has a good prognosis.

Discussing your prognosis and thinking about the future can be challenging and stressful. It may help to talk with family and friends. You can also call Cancer Council 13 11 20 if you need more information or emotional support.

Your doctor will consider many factors in assessing your prognosis. These include: test results; the type of ovarian cancer you have; the grade; genetic factors; your response to treatment; and other factors such as your age, fitness and overall health.

This information was last reviewed in April 2018
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