Cancer Staging

1a: Growth limited to ovaries, no ascites containing malignant cells, no tumor on external surface, capsule intact

1b: Growth limited to both ovaries, no ascites containing malignant cells, no tumor on external surface, capsule intact

1c: Tumor either 1a/b with tumor on surface of ovaries, capsule ruptured or ascites with malignant cells or positive peritoneal washings

2a: Extension to uterus or fallopian tubes

2b: Extension to other pelvic structures

2c: Either 2a/b with tumor on surface of ovaries, capsule ruptured or ascites with malignant cells or positive peritoneal washings

3a: Grossly limited to true pelvis with negative nodes, but histologically proven microscopic seeding of abdo peritoneal surfaces

3b: Histologically confirmed implants of abdominal peritoneal surfaces none exceeding 2cm, nodes negative

3c: Abdominal implants >2cm OR positive retroperitoneal or inguinal nodes

4: Growth involving one or both ovaries with distant mets.  If pleural effusion present, must have positive cytology.  Includes parenchymal liver mets.

• IA1: <3mm invasion, <7mm
• - <1% Nodes

Tx: Cone Biopsy, Simple Hysterectomy (97% 5 yr)

• IA2: 3-5mm invasion but <7mm horizontal spread
• - 3-8% Nodes

Tx: SNL (if -ve Radical Hyst/Trachelectomy) (95% 5 yr)

IB1: >5mm invasion, <4cm spread

Tx: SNL (if -ve Radical Hyst/Trachelectomy) (90% 5 yr)

IB2: > 4cm spread, confined to Cx

Tx: Radiation/Cisplatin (75% 5 yr)

IIA: beyond Cx, no parametrial involvement

Tx: Chemoradiation (70% 5 yr)

IIB: Parametrial invasion

Tx: Chemoradiation (65% 5 yr)

IIIA: lower 1/3 of vagina, no extension to pelvic sidewall

Tx: Chemoradiation (40% 5 yr)

IIIB: Extends to pelvic sidewall +/or causes hydronephrosis

Tx: Chemoradiation (40% 5 yr)

IVA: bladder, rectum +/or beyond true pelvis

Tx: Chemoradiation (20% 5 yr)

IVB: distant mets

Tx: Chemoradiation (10% 5 yr)