Staging is the process of finding out how far the cancer has spread. This is very important because ovarian cancers at different stages are treated differently. Once a stage has been assigned, it doesn't change, even if the cancer spreads to other places in the body or comes back later. Staging is usually done during surgery.

One of the goals of surgery for ovarian cancer is to get tissue samples for staging. Samples of tissues are taken from different parts of the pelvis and belly (abdomen) and looked under the microscope.

The AJCC/TNM system is used to stage the cancer. This system describes the cancer in terms of the extent of the tumor (T), whether or not it has spread to nearby lymph nodes (N), and whether it has spread to organs farther away (or metastasized, M).

Once the TNM groups have been decided, the information is combined to give a number from 1 to 4. The stage is expressed as a Roman numeral. In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more serious cancer.

Summary of ovarian cancer stages

Stage I: The cancer is only in the ovary (or ovaries).

Stage II: Cancer is in one or both ovaries and has spread to other organs in the pelvis such as the bladder, colon, rectum, or uterus.

Stage III: The cancer is in one or both ovaries and has spread to one or both of the following: the lining of the belly (abdomen) or the lymph nodes.

Stage IV: This is the most advanced stage. The cancer has spread from one or both ovaries to distant organs such as the liver or lungs, or there may be cancer cells in the fluid around the lungs.

Recurrent: The cancer has come back (recurred) after treatment.

The above stages can be further divided into sub-groups. Ask your doctor to explain the exact stage of your cancer in terms you can understand.

Last Medical Review: 09/14/2009
Last Revised: 09/14/2009