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28

NCCN Guidelines for Patients

®

:

Ovarian Cancer, Version 1.2017

3

Cancer staging

Ovarian cancer stages

Stage III

Cancer in is one or both ovaries. It has spread

outside the pelvis to tissues in the belly (abdomen).

And, one or both of the following has happened: 1)

cancer has spread to the tissue lining the inside

of the abdomen (peritoneum); or 2) cancer may

have spread to lymph nodes in the back part of the

abdomen behind the peritoneum.

See Figure 10.

Stage IIIA1

– Cancer has spread outside the pelvis,

but only to lymph nodes in the back part of the

abdomen—called retroperitoneal lymph nodes.

†

†

Stage IIIA1 (i)

– Cancer in the lymph nodes is

10 mm (millimeters) or smaller.

†

†

Stage IIIA1 (ii)

– Cancer in the lymph nodes is

larger than 10 mm.

Stage IIIA2

– Cancer has spread to the tissue lining

the abdomen, but it is so small it can only be seen

with a microscope. Cancer may have also spread to

lymph nodes in the back of the abdomen.

Stage IIIB

– Cancer has spread to the tissue

lining the abdomen and it can be seen without a

microscope. The areas of cancer spread are 2 cm

(centimeters) or smaller. Cancer may have also

spread to lymph nodes in the back of the abdomen.

Stage IIIC

– Cancer has spread to the tissue

lining the abdomen and it can be seen without a

microscope. The areas of cancer spread are larger

than 2 cm. Cancer may have spread to lymph nodes

in the back of the abdomen. It may have also spread

to the outer surface of the liver or spleen.

Stage IV

Cancer has spread to distant sites in the body

beyond the pelvis and abdomen. Cancer may have

spread to distant organs such as the lungs, brain,

or skin. It may have spread to the inside of the liver

or spleen. Cancer may have also spread to lymph

nodes outside the abdomen—called distant lymph

nodes.

See Figure 11.

Stage IVA

– Cancer cells are found in the fluid

around the lungs—called pleural effusion. But,

cancer has not spread anywhere else outside the

abdomen.

Stage IVB

– Cancer has spread to the inside of the

liver or spleen, to distant lymph nodes, or to other

organs outside the abdomen.