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Stages of ovarian cancer

Women discussing ovarian cancer

This page gives information about the stages of ovarian cancer. You can find the following information

 

A quick guide to what's on this page

What is staging?

The stage of a cancer tells the doctor how far it has spread. It is important because doctors often decide on treatment according to the stage. They normally use a simple staging system for ovarian cancer. This system has four stages, numbered 1 to 4

  • Stage 1 ovarian cancer means the cancer is completely inside the ovaries, or just on the surface
  • Stage 2 means the cancer has grown outside the ovary or ovaries, but is within the area circled by the hip bones (the pelvis)
  • Stage 3 means the cancer has grown outside the pelvis into the abdominal cavity or there is cancer in the lymph nodes in the upper abdomen, groin or behind the womb
  • Stage 4 means the cancer has spread into body organs further away, such as the liver or lungs. If there is cancer on the surface of the liver but not within the liver itself, then the cancer is still stage 3

Doctors also give a grade to the cancer, depending on how the cells look under the microscope. This gives doctors an idea of how the cancer may behave. Generally, low grade (or grade 1) cancers tend to grow more slowly and are are less likely to spread than high grade (or grade 3) cancers.


CR PDF Icon You can view and print the quick guides for all the pages in the treating ovarian cancer section.
 

 

Staging ovarian cancer

The stage of a cancer tells the doctor how far it has grown and if it has spread. The tests and scans you have to diagnose your cancer will give some information about the stage. It is important because your specialist will decide on your treatment according to the stage of your cancer.

Doctors use a simple 1 to 4 staging system for ovarian cancer. It is called the FIGO system after its authors - the International Federation of Gynaecological Oncologists.

 

Stage 1

Stage 1 ovarian cancer means the cancer is only in the ovaries. It is divided into 3 groups

  • Stage 1a - the cancer is completely inside one ovary
  • Stage 1b - the cancer is completely inside both ovaries
  • Stage 1c - as well as cancer in one or both ovaries, there is some cancer on the surface of an ovary or there are cancer cells in fluid taken from inside your abdomen during surgery or the ovary ruptures (bursts) before or during surgery

Diagram showing stage 1 ovarian cancer

 

Stage 2

Stage 2 means the cancer has grown outside the ovary or ovaries and is growing within the area circled by your hip bones (the pelvis). There may also be cancer cells in the abdomen.  So stage 2 cancer can be

  • 2a - the cancer has grown into the fallopian tubes or the womb
  • 2b - the cancer has grown into other tissues in the pelvis, for example the bladder or rectum
  • 2c - the cancer has grown into other tissues in the pelvis and there are cancer cells in fluid taken from inside your abdomen

     

Diagram showing stage 2A to 2C ovarian cancer

 

Stage 3

Stage 3 cancer of the ovary means the cancer has spread outside the area surrounded by your hip bones (the pelvis) into the abdominal cavity. Your cancer is also stage 3 if cancer is found in the lymph nodes in your upper abdomen (tummy), groin or behind the womb. So stage 3 cancer can be

  • 3a - using a microscope, cancer growths can be seen in tissue taken from the lining of the abdomen
  • 3b - there are visible tumour growths on the lining of the abdomen that are 2cm across or smaller
  • 3c - there are tumour growths larger than 2cm on the lining of the abdomen, or cancer in lymph nodes in the upper abdomen, groin or behind the womb, or both

Diagram showing stage 3A to 3C ovarian cancer

 

Stage 4

Stage 4 ovarian cancer means the cancer has spread to other body organs some distance from the ovaries, such as the liver or lungs. But if ovarian cancer is only found on the surface of the liver and not within the liver itself, then the cancer is still stage 3.

Diagram showing stage 4 ovarian cancer

 

Grading ovarian cancer

The grade of a cancer means how the cells look under the microscope. The appearance of the cells gives doctors an idea of how quickly or slowly the cancer is likely to grow. There are 3 grades of ovarian cancer

  • Grade 1 or well differentiated
  • Grade 2 or moderately differentiated
  • Grade 3 or poorly differentiated (or undifferentiated)

As a normal cell grows and matures, it becomes specialised for its role and place in the body. This is called differentiation. Cancer cells can look very like normal cells and are described as well differentiated or low grade. These cancers are more likely to grow slowly.

If the cancer cells look underdeveloped and nothing like a normal cell, they are known as undifferentiated or high grade. These cancers tend to grow and spread more quickly than low grade cancers.

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Updated: 16 January 2014