Ovary tumor
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TNM and FIGO classification, staging of tumors of the ovary, fallopian tube and primary peritoneal carcinoma

Author: Indranil Chakrabarti, M.D. (see Authors page)

Revised: 14 January 2016, last major update January 2016

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Staging [title] ovary
Definition / General
  • Clinical and pathologic categories are the same
Classification
TNM Primary tumor (T) and FIGO stages in ( )

  • TX: Primary tumor cannot be assessed
  • T0: No evidence of primary tumor
  • T1(I): Tumor limited to the ovaries
  • T1a(IA): Tumor limited to one ovary (capsule intact) or fallopian tube surface; malignant cells in ascites or peritoneal washings
  • T1b(IB): Tumor limited to one or both ovaries (capsules intact) or fallopian tubes; no tumor on ovarian or fallopian tube surface, no malignant cells in ascites or peritoneal washings
  • T1c(IC): Tumor limited to one or both ovaries or fallopian tubes with any of following:
    • T1c1(IC1): Surgical spill
    • T1c2(IC2): Capsule ruptured before surgery or tumor on ovarian or fallopian tube surface
    • T1c3(IC3): Malignant cells in ascites or peritoneal washings
    • T2(II): Tumor involves one or both ovaries or fallopian tubes with pelvic extension below pelvic brim or primary peritoneal cancer
  • T2a(IIA): Extension and/or implants on uterus and/or fallopian tubes and/or ovaries; no malignant cells in ascites or peritoneal washings
  • T2b(IIB): Extension to other pelvic intraperitoneal tissues
  • T3(III): Tumor involves one or both ovaries or fallopian tubes, or primary and/or peritoneal cancer, with cytologically or histologically confirmed
    • N1: Tumor spread to the peritoneum outside the pelvis and/or metastasis to the retroperitoneal lymph nodes
    • N1(IIIA1): Retroperitoneal lymph node metastasis only (cytologically or histologically proven)
    • N1a(IIIA1i): Lymph node metastasis up to 10 mm in greatest dimension
    • N1b(IIIA1ii): Lymph node metastasis more than 10 mm in greatest dimension
  • T3a(IIIA2): Microscopic extrapelvic (above the pelvic brim) peritoneal involvement with or without positive retroperitoneal lymph nodes
  • T3b(IIIB): Macroscopic peritoneal metastasis beyond pelvis up to 2 cm in greatest dimension or less in greatest dimension with or without retroperitoneal lymph node metastasis
  • T3c(IIIC): Macroscopic peritoneal metastasis beyond pelvis more than 2 cm in greatest dimension with or without retroperitoneal lymph node metastasis (excludes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ
  • M1(IV): Distant metastasis excluding peritoneal metastases
  • M1a(IVA): Pleural effusion with positive cytology
  • M1b(IVB):Parenchymal metastases and metastases to extra-abdominal organs (including inguinal lymph nodes and lymph node s outside the abdominal cavity)

Regional lymph nodes (N) and FIGO stages in ( )

  • NX: Regional lymph nodes cannot be assessed
  • N0: No regional lymph node metastasis
  • N1: Regional lymph node metastasis
    • N1a: Lymph node metastasis up to 10 mm in greatest dimension
    • N1b: Lymph node metastasis more than 10 mm in greatest dimension

Distant metastasis (M) and FIGO stages in ( )

  • M0: No distant metastasis
  • M1: Distant metastasis
    • M1a: Pleural effusion with positive cytology
    • M1b: Parenchymal metastases and metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity)

p TNM Pathological classification

  • The pT and pN categories correspond to the T and N categories
  • pM1: Distant metastasis microscopically confirmed
  • Note: pM0 and pMX are not valid categories
  • pN0 Histological examination of a pelvic lymphadenectomy specimen will ordinarily include 10 or more lymph nodes; if the lymph nodes are negative, but the number examined is not met, classify as pN0
Interpretation
Stage grouping
Stage
IA T1a N0 M0
IB T1b N0 M0
IC1 T1c1 N0 M0
IC2 T1c2 N0 M0
IC3 T1c3 N0 M0
IIA T2a N0 M0
IIB T2b N0 M0
IIC T2C N0 M0
IIIA1 T1/T2 N1 M0
IIIA2 T3a N0/N1 M0
IIIB T3b N0/N1 M0
IIIC T3c N0/N1 M0
IV Any T Any N Any M