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Ovarian Epithelial Cancer Treatment (PDQ®)

Patient Version
Last Modified: 10/26/2011

Stages of Ovarian Epithelial Cancer

Key Points for This Section


After ovarian epithelial cancer has been diagnosed, tests are done to find out if cancer cells have spread within the ovaries or to other parts of the body.

The process used to find out if cancer has spread within the ovary or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following procedures may be done:

  • Laparotomy: The doctor cuts into the abdomen and carefully looks at all the organs to see if they contain cancer. The doctor will also do a biopsy (cut out small pieces of tissue so they can be looked at under a microscope to see whether they contain cancer). Usually the doctor will remove the cancer and organs that contain cancer during the laparotomy. (See the Treatment Options by Stage 1 section.)
  • Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.

There are three ways that cancer spreads in the body.

The three ways that cancer spreads in the body are:

  • Through tissue. Cancer invades the surrounding normal tissue.
  • Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
  • Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

The following stages are used for ovarian epithelial cancer:

Stage I

In stage I, cancer is found in one or both ovaries. Stage I is divided into stage IA, stage IB, and stage IC.

Stage II

In stage II, cancer is found in one or both ovaries and has spread into other areas of the pelvis. Stage II is divided into stage IIA, stage IIB, and stage IIC.

Stage III

In stage III, cancer is found in one or both ovaries and has spread outside the pelvis to other parts of the abdomen and/or nearby lymph nodes. Stage III is divided into stage IIIA, stage IIIB, and stage IIIC.

  • Stage IIIA: The tumor is found in the pelvis only, but cancer cells that can be seen only with a microscope have spread to the surface of the peritoneum (tissue that lines the abdominal wall and covers most of the organs in the abdomen), the small intestines, or the tissue that connects the small intestines to the wall of the abdomen.
  • Stage IIIB: Cancer has spread to the peritoneum and the cancer in the peritoneum is 2 centimeters or smaller.
  • Stage IIIC: Cancer has spread to the peritoneum and the cancer in the peritoneum is larger than 2 centimeters and/or cancer has spread to lymph nodes in the abdomen.

Cancer that has spread to the surface of the liver is also considered stage III ovarian cancer.

Stage IV

In stage IV, cancer has spread beyond the abdomen to other parts of the body, such as the lungs or tissue inside the liver.

Cancer cells in the fluid around the lungs is also considered stage IV ovarian cancer.



Glossary Terms

abdomen (AB-doh-men)
The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
abdominal (ab-DAH-mih-nul)
Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
biopsy (BY-op-see)
The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.
blood (blud)
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
bone cancer (bone KAN-ser)
Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).
breast cancer (brest KAN-ser)
Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.
cancer (KAN-ser)
A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.
capillary (KA-pih-layr-ee)
The smallest type of blood vessel. A capillary connects an arteriole (small artery) to a venule (small vein) to form a network of blood vessels in almost all parts of the body. The wall of a capillary is thin and leaky, and capillaries are involved in the exchange of fluids and gases between tissues and the blood.
capsule (KAP-sul)
In medicine, a sac of tissue and blood vessels that surrounds an organ, joint, or tumor. A capsule is also a form for medicine that is taken by mouth. It usually has a shell made of gelatin with the medicine inside.
cavity (KA-vih-tee)
A hollow area or hole. It may describe a body cavity (such as the space within the abdomen) or a hole in a tooth caused by decay.
cell (sel)
The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.
centimeter (SEN-tih-MEE-ter)
A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.
fallopian tube (fuh-LOH-pee-in...)
A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.
fluid (FLOO-id)
A substance that flows smoothly and takes the shape of its container. Liquids and gases are fluids.
invasive cancer (in-VAY-siv KAN-ser)
Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer.
laparotomy (LA-puh-RAH-toh-mee)
A surgical incision made in the wall of the abdomen.
liver (LIH-ver)
A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.
lung (lung)
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
lymph (limf)
The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.
lymph node (limf node)
A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.
lymph vessel (limf ...)
A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.
lymphatic system (lim-FA-tik SIS-tem)
The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.
metastasis (meh-TAS-tuh-sis)
The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-tuh-SEEZ).
microscope (MY-kroh-SKOPE)
An instrument that is used to look at cells and other small objects that cannot be seen with the eye alone.
organ (OR-gun)
A part of the body that performs a specific function. For example, the heart is an organ.
ovarian cancer (oh-VAYR-ee-un KAN-ser)
Cancer that forms in tissues of the ovary (one of a pair of female reproductive glands in which the ova, or eggs, are formed). Most ovarian cancers are either ovarian epithelial carcinomas (cancer that begins in the cells on the surface of the ovary) or malignant germ cell tumors (cancer that begins in egg cells).
ovary (OH-vuh-ree)
One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.
pathologist (puh-THAH-loh-jist)
A doctor who identifies diseases by studying cells and tissues under a microscope.
pelvis (PEL-vus)
The lower part of the abdomen, located between the hip bones.
peritoneal cavity (PAYR-ih-toh-NEE-ul KA-vuh-tee)
The space within the abdomen that contains the intestines, the stomach, and the liver. It is bound by thin membranes.
peritoneum (PAYR-ih-toh-NEE-um)
The tissue that lines the abdominal wall and covers most of the organs in the abdomen.
primary tumor (PRY-mayr-ee TOO-mer)
The original tumor.
small intestine (... in-TES-tin)
The part of the digestive tract that is located between the stomach and the large intestine.
stage (stayj)
The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.
stage I ovarian epithelial cancer (...oh-VAYR-ee-un EH-pih-THEE-lee-ul KAN-ser)
Cancer is found in one or both ovaries. Stage I is divided into stages IA, IB, and IC. In stage IA, cancer is found inside a single ovary. In stage IB, cancer is found inside both ovaries. In stage IC, cancer is found inside one or both ovaries and one of the following is true: (1) cancer is also found on the outside surface of one or both ovaries; or (2) the capsule (outer covering) of the ovary has ruptured (broken open); or (3) cancer cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal cavity).
stage II ovarian epithelial cancer (... oh-VAYR-ee-un EH-pih-THEE-lee-ul KAN-ser)
Cancer is found in one or both ovaries and has spread into other areas of the pelvis. Stage II is divided into stages IIA, IIB, and IIC. In stage IIA, cancer has spread to the uterus and/or the fallopian tubes. In stage IIB, cancer has spread to other tissue within the pelvis. In stage IIC, cancer is found in one or both ovaries and has spread to the uterus and/or fallopian tubes, or to other tissue within the pelvis. Also, one of the following is true: (1) cancer is also found on the outside surface of one or both ovaries; or (2) the capsule (outer covering) of the ovary has ruptured (broken open); or (3) cancer cells are found in the fluid of the peritoneal cavity (the body cavity that contains most of the organs in the abdomen) or in washings of the peritoneum (tissue lining the peritoneal cavity).
stage III ovarian epithelial cancer (...oh-VAYR-ee-un EH-pih-THEE-lee-ul KAN-ser)
Cancer is found in one or both ovaries and has spread outside the pelvis to other parts of the abdomen and/or nearby lymph nodes. Stage III is divided into stages IIIA, IIIB, and IIIC. In stage IIIA, the tumor is found in the pelvis only, but cancer cells that can be seen only with a microscope have spread to the surface of the peritoneum (tissue that lines the abdominal wall and covers most of the organs in the abdomen), the small intestines, or the tissue that connects the small intestines to the wall of the abdomen. In stage IIIB, cancer has spread to the peritoneum and the cancer in the peritoneum is 2 centimeters or smaller. In stage IIIC, cancer has spread to the peritoneum and the cancer in the peritoneum is larger than 2 centimeters and/or cancer has spread to lymph nodes in the abdomen. Cancer that has spread to the surface of the liver is also considered stage III ovarian cancer.
stage IV ovarian epithelial cancer (...oh-VAYR-ee-un EH-pih-THEE-lee-ul KAN-ser)
Cancer has spread beyond the abdomen to other parts of the body, such as the lungs or tissue inside the liver. Cancer cells in the fluid around the lungs is also considered stage IV ovarian cancer.
staging (STAY-jing)
Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.
thoracentesis (THOR-uh-sen-TEE-sis)
Removal of fluid from the pleural cavity through a needle inserted between the ribs.
tissue (TIH-shoo)
A group or layer of cells that work together to perform a specific function.
tumor (TOO-mer)
An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.
uterus (YOO-teh-rus)
The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called womb.
vein (vayn)
A blood vessel that carries blood to the heart from tissues and organs in the body.

Table of Links

1http://www.cancer.gov/cancertopics/pdq/treatment/ovarianepithelial/Patient/Page
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