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The staging, grading and prognosis of ovarian cancer
The tests completed by your specialist show whether you have ovarian cancer and whether it has spread to other parts of the body. This process is called staging and it helps your health care team recommend the best treatment for you.
The staging system most commonly used for ovarian cancer is the International Federation of Gynecology and Obstetrics (FIGO) system. It divides ovarian cancer into four stages.
- Stages 1–2 mean it is early ovarian cancer.
- Stages 3–4 mean the cancer is advanced. About 7 out of 10 cases of ovarian cancer are diagnosed at stage 3 or 4.
Stages of ovarian cancer
The four stages of ovarian cancer in the FIGO system may be divided into sub-stages, such as A, B, C, which indicate increasing amounts of tumour.
|stage 1||Cancer is in one or both ovaries or fallopian tubes only.|
|stage 2||Cancer is in one or both ovaries or fallopian tubes and has spread to other organs in the pelvis (uterus, bladder or bowel).|
|stage 3||Cancer is in one or both ovaries or fallopian tubes and has spread outside the pelvis to the lining of the abdomen (peritoneum) or to nearby lymph nodes.|
|stage 4||The cancer has spread outside the abdomen to distant organs such as the lungs or liver.|
Grading ovarian cancer
The cancer will also be given a grade. This is a score that describes how the cancer cells look compared to normal cells under a microscope. The grade suggests how quickly the cancer may grow.
Different systems are used to grade ovarian cancer. The system used depends on the type of ovarian cancer.
Epithelial ovarian cancer is simply divided into low grade and high grade and a number is not given. The most common type of ovarian cancer is high-grade serous cancer. All other types of ovarian cancers are graded as 1, 2 and 3 – 1 being low grade and 3 being high grade.
Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for anyone to predict the exact course of the disease.
To work out your prognosis, your doctor will consider test results; the type of ovarian cancer and its stage and grade; genetic factors; likelihood of response to treatment; and factors such as your age, fitness and overall health.
Epithelial cancer – If epithelial ovarian cancer is diagnosed and treated when the cancer is inside the ovary (stage 1), it has a good prognosis. Many cases of more advanced cancer may respond well to treatment, but the cancer often comes back (recurs) and further treatment is needed.
Stromal cell and germ cell tumours – These can usually be treated successfully, although there may be a small risk the cancer will come back and need further treatment.
Borderline tumour – This can usually be treated successfully with surgery alone.
Discussing your prognosis can be challenging and stressful. It may help to talk with family and friends. You can also call Cancer Council 13 11 20.
Listen to our podcast episode ‘Coping with a Cancer Diagnosis’
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This information is reviewed by
This information was last reviewed April 2022 by the following expert content reviewers: Dr Nisha Jagasia, Gynaecological Oncologist, Mater Hospital Brisbane, QLD; Sue Hayes, Consumer; Bronwyn Jennings, Gynaecology Oncology Clinical Nurse Consultant, Mater Health, QLD; Dr Andrew Lee, Radiation Oncologist, Canberra Region Cancer Centre and Canberra Hospital, ACT; A/Prof Tarek Meniawy, Medical Oncologist, Sir Charles Gairdner Hospital, WA; Caitriona Nienaber, Cancer Council WA; Jane Power, Consumer; A/Prof Sam Saidi, Senior Staff Specialist, Gynaecological Oncology, Chris O’Brien Lifehouse, NSW.