Ovarian germ cell tumor staging: Difference between revisions
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{{CMG}}{{AE}} {{Sahar}} {{MD}} | {{CMG}}{{AE}} {{Sahar}} {{MD}} | ||
==Overview== | ==Overview== | ||
According to the FIGO and TNM [[cancer staging]] system, there are 4 stages of ovarian germ cell tumor.<ref name= mmm> Stage Information for Ovarian Germ Cell Tumors. http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_8. URL Accessed on November 5, 2015</ref> | According to the [[FIGO]] and [[TNM]] [[cancer staging]] system, there are 4 [[stages]] of [[ovarian]] [[germ cell]] [[tumor]].<ref name="mmm">Stage Information for Ovarian Germ Cell Tumors. http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_8. URL Accessed on November 5, 2015</ref> | ||
==Staging== | ==Staging== | ||
Ovarian germ cell tumor is surgically staged using the [[International Federation of Gynecology and Obstetrics|FIGO]] and TNM [[cancer staging]] system:<ref name=mmm> Stage Information for Ovarian Germ Cell Tumors. http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_8. URL Accessed on November 5, 2015</ref><ref name="Prat2014">{{cite journal|last1=Prat|first1=Jaime|title=Staging classification for cancer of the ovary, fallopian tube, and peritoneum|journal=International Journal of Gynecology & Obstetrics|volume=124|issue=1|year=2014|pages=1–5|issn=00207292|doi=10.1016/j.ijgo.2013.10.001}}</ref> | Ovarian germ cell tumor is surgically staged using the [[International Federation of Gynecology and Obstetrics|FIGO]] and TNM [[cancer staging]] system:<ref name="mmm">Stage Information for Ovarian Germ Cell Tumors. http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_8. URL Accessed on November 5, 2015</ref><ref name="Prat2014">{{cite journal|last1=Prat|first1=Jaime|title=Staging classification for cancer of the ovary, fallopian tube, and peritoneum|journal=International Journal of Gynecology & Obstetrics|volume=124|issue=1|year=2014|pages=1–5|issn=00207292|doi=10.1016/j.ijgo.2013.10.001}}</ref> | ||
{| {{table}} | {| {{table}} cellpadding="4" cellspacing="0" style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" | ||
| align="center" style="background:#f0f0f0;"|'''Tumor size''' | | align="center" style="background:#f0f0f0;" |'''Tumor size''' | ||
| align="center" style="background:#f0f0f0;"|'''FIGO stage''' | | align="center" style="background:#f0f0f0;" |'''FIGO stage''' | ||
| align="center" style="background:#f0f0f0;"|'''Finding''' | | align="center" style="background:#f0f0f0;" |'''Finding''' | ||
|- | |- | ||
| T1 | | T1 | ||
| I||Growth limited to the ovaries | | I||Growth limited to the [[ovaries]] | ||
|- | |- | ||
| T1a | | T1a | ||
| Ia||Growth limited to one ovary; no ascites present containing malignant cells. No tumor on the external surface; capsule intact | | Ia||Growth limited to one [[ovary]]; no [[ascites]] present containing [[malignant]] cells. No [[tumor]] on the external [[Surface anatomy|surface]]; [[capsule]] intact | ||
|- | |- | ||
| T1b | | T1b | ||
| Ib||Growth limited to both ovaries; no ascites present containing malignant cells. No tumor on the external surfaces; capsules intact | | Ib||Growth limited to both [[ovaries]]; no [[ascites]] present containing [[malignant]] cells. No [[tumor]] on the external [[Surface anatomy|surfaces]]; [[capsules]] intact | ||
|- | |- | ||
| T1c | | T1c | ||
| Ic||Tumor either stage Ia or Ib, but with the tumor on surface of one or both ovaries, or with capsule ruptured, or with ascites present containing malignant cells, or with positive peritoneal washings | | Ic||[[Tumor]] either stage Ia or Ib, but with the [[tumor]] on [[Surface anatomy|surface]] of one or both [[ovaries]], or with [[capsule]] [[Rupture|ruptured]], or with [[ascites]] present containing [[malignant]] cells, or with positive [[peritoneal]] washings | ||
|- | |- | ||
| T2 | | T2 | ||
| II||Growth involving one or both ovaries with pelvic extension | | II||Growth involving one or both [[ovaries]] with [[pelvic]] extension | ||
|- | |- | ||
| T2a | | T2a | ||
| IIa||Extension and/or metastases to the uterus and/or tubes | | IIa||Extension and/or [[metastases]] to the [[uterus]] and/or tubes | ||
|- | |- | ||
| T2b | | T2b | ||
| IIb||Extension to other pelvic tissues | | IIb||Extension to other [[pelvic]] tissues | ||
|- | |- | ||
| T2c | | T2c | ||
| IIc||Tumor either stage IIa or IIb, but with the tumor on surface of one or both ovaries, or with capsule(s) ruptured, or with ascites present containing malignant cells, or with positive peritoneal washings | | IIc||[[Tumor]] either stage IIa or IIb, but with the [[tumor]] on [[Surface anatomy|surface]] of one or both [[ovaries]], or with [[Capsule|capsule(s)]] ruptured, or with [[ascites]] present containing [[malignant]] cells, or with positive [[peritoneal]] washings | ||
|- | |- | ||
| T3 | | T3 | ||
| III||Tumor involving one or both ovaries with histologically confirmed peritoneal implants outside the pelvis and/or positive regional lymph nodes. Superficial liver metastases equal stage III. The tumor is limited to the true pelvis, but with histologically proven malignant extension to small bowel or omentum | | III||[[Tumor]] involving one or both [[ovaries]] with [[histologically]] confirmed [[peritoneal]] implants outside the [[pelvis]] and/or positive regional [[lymph nodes]]. [[Superficial]] [[liver]] [[metastases]] equal stage III. The [[tumor]] is limited to the [[true pelvis]], but with [[histologically]] proven [[malignant]] extension to [[small bowel]] or [[omentum]] | ||
|- | |- | ||
| T3a | | T3a | ||
| IIIa||Tumor grossly limited to the true pelvis, with negative nodes, but with histologically confirmed microscopic seeding of abdominal peritoneal surfaces, or histologic proven extension to small bowel or mesentery | | IIIa||[[Tumor]] grossly limited to the [[true pelvis]], with negative [[Lymph node|nodes]], but with [[histologically]] confirmed microscopic seeding of [[abdominal]] [[peritoneal]] surfaces, or [[histologic]] proven extension to [[small bowel]] or [[mesentery]] | ||
|- | |- | ||
| T3b | | T3b | ||
| IIIb||Tumor of one or both ovaries with histologically confirmed implants, peritoneal metastasis of abdominal peritoneal surfaces, none exceeding 2 cm in diameter; nodes are negative | | IIIb||[[Tumor]] of one or both [[ovaries]] with [[histologically]] confirmed implants, [[peritoneal]] [[metastasis]] of [[abdominal]] [[peritoneal]] surfaces, none exceeding 2 cm in diameter; [[Lymph nodes|nodes]] are negative | ||
|- | |- | ||
| T3c | | T3c | ||
| IIIc||Peritoneal metastasis beyond the pelvis >2 cm in diameter and/or positive regional lymph nodes | | IIIc||[[Peritoneal]] [[metastasis]] beyond the pelvis >2 cm in diameter and/or positive regional [[lymph nodes]] | ||
|- | |- | ||
| AnyT | | AnyT | ||
| IV||Growth involving one or both ovaries with distant metastases. If pleural effusion is present, there must be positive cytology to allow a case to stage IV. Parenchymal liver metastasis equals stage IV | | IV||Growth involving one or both [[ovaries]] with distant [[Metastasis|metastases]]. If [[pleural effusion]] is present, there must be positive [[cytology]] to allow a case to stage IV. Parenchymal liver metastasis equals stage IV | ||
|} | |} | ||
*TNM staging of ovarian germ cell tumor: | *[[TNM staging system|TNM staging]] of [[Ovary|ovarian]] [[germ cell]] [[tumor]]: | ||
* M1: Distant metastasis, M1a: Pleural effusion with cytology, M1b: Liver or splenic parenchymal metastases; extra-abdominal metastases; transmural involvement of intestine | * M1: Distant [[metastasis]], M1a: [[Pleural effusion]] with [[cytology]], M1b: [[Liver]] or [[splenic]] [[parenchymal]] [[metastases]]; extra-[[abdominal]] [[metastases]]; transmural involvement of [[intestine]] | ||
{| {{table}} | {| {{table}} cellpadding="4" cellspacing="0" style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" | ||
| align="center" style="background:#f0f0f0;"|'''FIGO stage''' | | align="center" style="background:#f0f0f0;" |'''FIGO stage''' | ||
| align="center" style="background:#f0f0f0;"|'''T''' | | align="center" style="background:#f0f0f0;" |'''T''' | ||
| align="center" style="background:#f0f0f0;"|'''N''' | | align="center" style="background:#f0f0f0;" |'''N''' | ||
| align="center" style="background:#f0f0f0;"|'''M''' | | align="center" style="background:#f0f0f0;" |'''M''' | ||
|- | |- | ||
| I | | I | ||
Revision as of 20:41, 8 March 2019
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Ovarian germ cell tumor Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Ovarian germ cell tumor staging On the Web |
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American Roentgen Ray Society Images of Ovarian germ cell tumor staging |
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Risk calculators and risk factors for Ovarian germ cell tumor staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Monalisa Dmello, M.B,B.S., M.D. [3]
Overview
According to the FIGO and TNM cancer staging system, there are 4 stages of ovarian germ cell tumor.[1]
Staging
Ovarian germ cell tumor is surgically staged using the FIGO and TNM cancer staging system:[1][2]
| Tumor size | FIGO stage | Finding |
| T1 | I | Growth limited to the ovaries |
| T1a | Ia | Growth limited to one ovary; no ascites present containing malignant cells. No tumor on the external surface; capsule intact |
| T1b | Ib | Growth limited to both ovaries; no ascites present containing malignant cells. No tumor on the external surfaces; capsules intact |
| T1c | Ic | Tumor either stage Ia or Ib, but with the tumor on surface of one or both ovaries, or with capsule ruptured, or with ascites present containing malignant cells, or with positive peritoneal washings |
| T2 | II | Growth involving one or both ovaries with pelvic extension |
| T2a | IIa | Extension and/or metastases to the uterus and/or tubes |
| T2b | IIb | Extension to other pelvic tissues |
| T2c | IIc | Tumor either stage IIa or IIb, but with the tumor on surface of one or both ovaries, or with capsule(s) ruptured, or with ascites present containing malignant cells, or with positive peritoneal washings |
| T3 | III | Tumor involving one or both ovaries with histologically confirmed peritoneal implants outside the pelvis and/or positive regional lymph nodes. Superficial liver metastases equal stage III. The tumor is limited to the true pelvis, but with histologically proven malignant extension to small bowel or omentum |
| T3a | IIIa | Tumor grossly limited to the true pelvis, with negative nodes, but with histologically confirmed microscopic seeding of abdominal peritoneal surfaces, or histologic proven extension to small bowel or mesentery |
| T3b | IIIb | Tumor of one or both ovaries with histologically confirmed implants, peritoneal metastasis of abdominal peritoneal surfaces, none exceeding 2 cm in diameter; nodes are negative |
| T3c | IIIc | Peritoneal metastasis beyond the pelvis >2 cm in diameter and/or positive regional lymph nodes |
| AnyT | IV | Growth involving one or both ovaries with distant metastases. If pleural effusion is present, there must be positive cytology to allow a case to stage IV. Parenchymal liver metastasis equals stage IV |
- TNM staging of ovarian germ cell tumor:
- M1: Distant metastasis, M1a: Pleural effusion with cytology, M1b: Liver or splenic parenchymal metastases; extra-abdominal metastases; transmural involvement of intestine
| FIGO stage | T | N | M |
| I | T1 | N0 | M0 |
| Ia | T1a | N0 | M0 |
| Ib | T1b | N0 | M0 |
| Ic | T1c | N0 | M0 |
| II | T2 | N0 | M0 |
| IIa | T2a | N0 | M0 |
| IIb | T2b | N0 | M0 |
| IIc | T2c | N0 | M0 |
| III | T3 | N0 | M0 |
| IIIa | T3a | N0/N1 | M0 |
| IIIb | T3b | N0/N1 | M0 |
| IIIc | T3c | N0/N1 | M0 |
| IV | AnyT | AnyN | M1 |
| IVa | AnyT | AnyN | M1a |
| IVb | AnyT | AnyN | M1b |
References
- ↑ 1.0 1.1 Stage Information for Ovarian Germ Cell Tumors. http://www.cancer.gov/types/ovarian/hp/ovarian-germ-cell-treatment-pdq#section/_8. URL Accessed on November 5, 2015
- ↑ Prat, Jaime (2014). "Staging classification for cancer of the ovary, fallopian tube, and peritoneum". International Journal of Gynecology & Obstetrics. 124 (1): 1–5. doi:10.1016/j.ijgo.2013.10.001. ISSN 0020-7292.