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Staging and Grading

Staging and Grading

The stage of your cancer describes how far the cancer has grown and how far it has spread. The main stages of ovarian cancer are numbered from 1 to 4 and each main stage has sub-stages (a, b, c). (You may also see the main stages written with Roman numerals: I, II, III and IV.)

This staging system is used for all ovarian cancers and for primary peritoneal cancer. Primary peritoneal cancers are usually either stage 3 or stage 4. Knowing the stage of your cancer is important because it helps your specialist to decide on the best treatment for you. It also gives a guide to the chances of the cancer coming back.

The tests and scans you have will provide some information for your doctor about the stage: the cancer’s size and whether it has spread to nearby tissue or other parts of your body. But until you have surgery your doctor might not be able to tell you the exact stage of your cancer.

Ovarian cancer tumours are graded as well as staged. They are graded as either high grade or low grade by the pathologist examining the cancer tissue under a microscope. Low-grade tumours are more similar to normal tissue, whereas high-grade tumours are less like normal tissue and may be more likely to spread.

Doctors around the world 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.

Serous cancers are commonly high grade and the most common type of advanced stage ovarian cancer.

StageWhat does this mean?
1The cancer is only in your ovary or ovaries, or just on the surface.
1aThe cancer is completely inside one ovary.
1bThe cancer is completely inside both ovaries.
1cThe cancer is in one or both ovaries and there is some cancer on the surface of an ovary or there are cancer cells found in fluid in your abdomen during surgery or the ovary ruptures before or during surgery.
2The cancer has spread outside your ovary or ovaries into your pelvis.
2aThe cancer has spread to your uterus or fallopian tubes, or both.
2bThe cancer has spread to nearby pelvic organs and may involve the surface of your bladder, uterus, fallopian tubes, bladder, sigmoid colon or rectum.
3The cancer has spread from your pelvis into your abdominal cavity or to your lymph nodes.
3aUsing a microscope, cancer cells can be seen in lymph tissue in the abdomen / in biopsies from the lining of your abdomen.
3bThere are visible tumour growths measuring 2 centimetres or less across in the lining of your abdomen.
3cThere are tumour growths measuring more than 2 centimetres across in the lining of your abdomen and may also have spread to your lymph nodes.
4The cancer has spread to the liver, lungs or other organs or is found in fluid surrounding the lung tissue.

More information

For more information on the stages or grading of ovarian cancer, and to speak with an ovarian cancer nurse, please don't hesitate to phone the Ovarian Cancer Australia Helpline on 1300 660 334 or email support@ovariancancer.net.au

Resilience Kit

For up-to-date, evidence based information on all aspects of living with ovarian cancer, and where to find support, download or order a free copy of our Resilience Kit

Acknowledgement flags

Ovarian Cancer Australia acknowledges the Traditional Owners of the land where our office is located, the Wurundjeri people of the Kulin Nation and we pay our respects to Elders past and present.