Staging Ovarian Cancer [18]

Staging is the process of finding out how far the cancer has spread. This process is very important because the stage of your cancer will determine your treatment. [18]

• Staging is usually done during surgery.
• One goal of surgery will be to obtain tissue samples and remove all cancer tumors larger than about 1/2 inch.
• Your tissue will then be analyzed under a microscope to help determine the stage of your cancer.
• Once a stage has been assigned, it doesn’t change, even if the cancer spreads to other areas of the body or comes back later.

The American Joint Committee on Cancer (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)
• 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 I (1) to IV (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.

Stage I: The cancer is contained within the ovary (or ovaries).

Stage II: Cancer is in 1 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 1 or both ovaries and has spread to the lining of the abdomen or to the lymph nodes.

Stage IV: This is the most advanced stage. The cancer has spread from 1 (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 subgroups.

Survival by stage [17]

The numbers below are based on patients diagnosed from 1995 to 1998. These numbers come from the American College of Surgeons' National Cancer Data Base.

Stage	Relative 5-Year Survival Rate
IA	92.7%
IB	85.4%
IC	84.7%
IIA	78.6%
IIB	72.4%
IIC	64.4%
IIIA	50.8%
IIIB	42.4%
IIIC	31.5%
IV	17.5%

Five-year survival rates are commonly used to discuss a patient's prognosis. The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. However, it is assumed that people will die of other causes. The 5-year relative rate compares the observed survival with the expected survival of people without ovarian cancer. Therefore, the relative rate only refers to deaths from ovarian cancer, excluding other causes.

Be sure to talk to your doctor and understand the stage of your ovarian cancer and how that will impact your treatment. To learn more, visit the American Cancer Society Web site at www.cancer.org.

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