April 24, 2023 - Of the 22,000 new cases of ovarian cancer diagnosed every year in the U.S., only about 8,000 will live; overall, ovarian cancer has a five-year survival rate of 30 percent. The prognosis for any ovarian cancer diagnosis depends on the “staging” of the cancer. Doctors use a four-part staging method which includes the type of tumor, whether the ovarian cancer has spread to the lymph nodes, whether the cancer has metastasized, and the stage of the cancer.
The stage of a cancer basically speaks to how much cancer is in the body and how serious the cancer is. The stage will also determine the best way to treat the ovarian cancer. Doctors may use the stage of the ovarian cancer when talking about survival rates. The actual stages of the cancer range from I through IV (1-4). The lower the number, the less the cancer is believed to have spread. A higher number indicates the cancer has spread further throughout the body.
The extent of the tumor (T) details whether the cancer has spread outside the ovary or fallopian tube. Whether the ovarian cancer has spread to nearby lymph nodes (N) determines whether the cancer has spread to the pelvic lymph nodes or the main artery running from the heart down along the back of the abdomen and pelvis.
The spread, or metastasis of ovarian cancer to distant organs (M) tells whether the cancer has spread to the fluid around the lungs, to the bones, or to more distant organs, like the liver. The numbers I-IV after the T, N, and M factors, provide more details about those factors. Cancer staging can be fairly complex, so it is essential that your doctor provides you with a comprehensive explanation regarding the staging of your ovarian cancer. Potential ovarian cancer stages include:
- I, T1, N0, M0—The ovarian cancer is only in the ovaries or fallopian tubes and has not yet spread to distant sites or to nearby lymph nodes.
- IA, T1a, N0, M0—The ovarian cancer is confined to the inside of one ovary (or is inside one fallopian tube), with no cancer on the outer surfaces of ovary or fallopian tube and no spread to nearby lymph nodes or distant sites
- IB, T1b, N0, M0—Just as in #2, but with cancer present in both ovaries or both fallopian tubes.
- IC, T1c, N0, M0—Cancer is in one or both ovaries or fallopian tubes, has not spread to nearby lymph nodes or distant sites, but any of the following are present:
- A surgical spill occurred during surgery; this means the tissue surrounding the tumor (capsule) broke, which could potentially allow cancerous cells to leak into the pelvis and abdominal region (IC1).
- The cancer is also on the outer surface of at least one ovary or fallopian tube, or the capsule ruptured prior to surgery (IC2).
- Cancer cells have been found in the fluid from the pelvis and abdomen (IC3).
- II, T2, N0, M0—The ovarian cancer is in one or both ovaries or fallopian tubes; while it has not spread to lymph nodes or distant sites, there is either primary peritoneal cancer, or the ovarian cancer has spread to other organs within the pelvis.
- IIA, T2a, N0, M0—While the ovarian cancer has not spread to nearby lymph nodes or distant sites, it has grown into the uterus, the fallopian tubes, or the ovaries.
- IIB, T2B, N0, M0—The ovarian cancer has not spread to nearby lymph nodes or distant sites, however, is on the outer surface or has grown into nearby pelvic organs.
- IIIA1, T1 or T2, N1, M0—The cancer has not spread to distant sites, however, has spread to pelvic lymph nodes; it is in one or both ovaries or fallopian tubes or there is primary peritoneal cancer which may have spread into nearby pelvic organs.
- IIIA2, T3a, N0 or N1, M0—While the cancer has not spread to distant sites, it may or may not have spread to retroperitoneal lymph nodes. The ovarian cancer is in one or both fallopian tubes or ovaries or there is primary peritoneal cancer. The cancer has spread into organs outside the pelvis. During surgery, there is no visible cancer in the abdomen, however tiny deposits of cancer are found in the abdominal lining when examined in the lab.
- IIIB, T3b, N0 or N1, M0—The ovarian cancer has not spread to distant sites and may or may not have spread to the retroperitoneal lymph nodes. During surgery, the deposits of the cancer are large enough to be seen by the surgeon but are no larger than ¾ of an inch across. The ovarian cancer is in one or both ovaries or fallopian tubes, or there is primary peritoneal cancer which has spread into organs outside the pelvis.
- IIIC, T3c, N0 or N1, M0—There is no spread of the ovarian cancer to distant sites, and it may or may not have spread to the retroperitoneal lymph nodes. The deposits of cancer are larger than ¾” across and may be seen outside the liver or spleen. The cancer is in one or both ovaries or fallopian tubes, or there is primary peritoneal cancer which has grown into the organs outside the pelvis.
- IVA, Any T level, Any N Level, M1a—Cancer cells have been found in the fluid surrounding the lungs, with no spread to the liver, spleen, intestine, or lymph nodes outside the abdomen.
- IVB, Any T level, Any N Level, M1b—The ovarian cancer has spread to the inside of the spleen or liver, to lymph nodes other than retroperitoneal lymph nodes, and to other organs or tissues outside the peritoneal cavity such as the bones or lungs.
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