Ovarian germ cell tumor staging: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 6: | Line 6: | ||
==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 [[Surgery|surgically]] staged using the [[International Federation of Gynecology and Obstetrics|FIGO]] and [[TNM classification|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> | ||
{| class="wikitable" | {| class="wikitable" | ||
| Line 39: | Line 39: | ||
|- | |- | ||
| T2c | | T2c | ||
| 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 | | 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)]] [[Rupture|ruptured]], or with [[ascites]] present containing [[malignant]] cells, or with positive [[peritoneal]] washings | ||
|- | |- | ||
| T3 | | T3 | ||
| Line 45: | Line 45: | ||
|- | |- | ||
| T3a | | T3a | ||
| IIIa2||[[Tumor]] grossly limited to the [[true pelvis]] with [[histologically]] confirmed microscopic seeding of [[abdominal]] [[peritoneal]] surfaces, or [[histologic]] proven extension to [[small bowel]] or [[mesentery]] with or without positive retroperitoneal lymph nodes | | IIIa2||[[Tumor]] grossly limited to the [[true pelvis]] with [[histologically]] confirmed [[microscopic]] seeding of [[abdominal]] [[peritoneal]] surfaces, or [[histologic]] proven extension to [[small bowel]] or [[mesentery]] with or without positive [[retroperitoneal]] [[lymph nodes]] | ||
|- | |- | ||
| 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 with or without metastasis to the retroperitoneal lymph nodes | | IIIb||[[Tumor]] of one or both [[ovaries]] with [[histologically]] confirmed [[implants]], [[peritoneal]] [[metastasis]] of [[abdominal]] [[peritoneal]] surfaces, none exceeding 2 cm in diameter with or without [[metastasis]] to the [[retroperitoneal]] [[Lymph node|lymph nodes]] | ||
|- | |- | ||
| T3c | | T3c | ||
| IIIc||[[Peritoneal]] [[metastasis]] beyond the pelvis >2 cm in diameter with or without metastasis to the retroperitoneal lymph nodes (includes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ) | | IIIc||[[Peritoneal]] [[metastasis]] beyond the pelvis >2 cm in diameter with or without metastasis to the [[retroperitoneal]] [[lymph nodes]] (includes extension of tumor to capsule of [[liver]] and [[spleen]] without [[parenchymal]] involvement of either [[Organ (anatomy)|organ]]) | ||
|- | |- | ||
| AnyT | | AnyT | ||
| 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. | | 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. | ||
|- | |- | ||
|+ | |+ | ||
| Line 65: | Line 65: | ||
|- | |- | ||
| N0 | | N0 | ||
| ||No lymph node involvement | | ||No [[lymph node]] involvement | ||
|- | |- | ||
| N0(i+) | | N0(i+) | ||
| ||Tumor cells are present in regional lymph node(s), no greater than 0.2 mm | | ||[[Tumor cell|Tumor cells]] are present in regional [[Lymph nodes|lymph node(s)]], no greater than 0.2 mm | ||
|- | |- | ||
| N1 | | N1 | ||
| IIIA1||Histologically confirmed | | IIIA1||[[Histologically]] confirmed [[Retroperitoneal|retroperitonea]]<nowiki/>l [[lymph nodes]] | ||
|- | |- | ||
| N1a | | N1a | ||
| IIIA1i||Metastasis <and= 10 mm in greatest dimension | | IIIA1i||[[Metastasis]] <and= 10 mm in greatest dimension | ||
|- | |- | ||
| N1b | | N1b | ||
| IIIA1ii||Metastasis more than 10 mm in greatest dimension | | IIIA1ii||[[Metastasis]] more than 10 mm in greatest dimension | ||
|- | |- | ||
|+ | |+ | ||
| Line 88: | Line 88: | ||
|- | |- | ||
| M0 | | M0 | ||
| ||No distant metastasis | | ||No distant [[metastasis]] | ||
|- | |- | ||
| M1 | | M1 | ||
| IV||Distant metastasis, including positive cytology of pleural effusion; liver or splenic parenchymal metastasis; metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); and transmural involvement of intestine | | IV||Distant [[metastasis]], including positive [[cytology]] of [[pleural effusion]]; [[liver]] or [[splenic]] [[parenchymal]] [[metastasis]]; [[metastasis]] to extra-[[abdominal]] [[organs]] (including [[inguinal lymph nodes]] and [[lymph nodes]] outside the [[abdominal cavity]]); and transmural involvement of [[intestine]] | ||
|- | |- | ||
| M1a | | M1a | ||
| IVa||Pleural effusion with positive cytology | | IVa||[[Pleural effusion]] with positive [[cytology]] | ||
|- | |- | ||
| M1b | | M1b | ||
| IVb||Liver or splenic parenchymal metastases; metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); transmural involvement of intestine | | IVb||[[Liver]] or [[splenic]] [[parenchymal]] [[metastases]]; [[metastases]] to extra-[[abdominal]] [[organs]] (including [[inguinal lymph nodes]] and [[lymph nodes]] outside the [[abdominal]] [[Abdominal cavity|cavity]]); transmural involvement of [[intestine]] | ||
|- | |- | ||
|} | |} | ||
Revision as of 14:28, 14 March 2019
|
Ovarian germ cell tumor Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Ovarian germ cell tumor staging On the Web |
|
American Roentgen Ray Society Images of Ovarian germ cell tumor staging |
|
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.
Staging
Ovarian germ cell tumor is surgically staged using the FIGO and TNM cancer staging system:[1][2]
| Primary tumor | ||
|---|---|---|
| Tumor size | FIGO stage | Finding |
| T1 | I | Growth limited to one or both 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 one or 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 | IIIa2 | Tumor grossly limited to the true pelvis with histologically confirmed microscopic seeding of abdominal peritoneal surfaces, or histologic proven extension to small bowel or mesentery with or without positive retroperitoneal lymph nodes |
| T3b | IIIb | Tumor of one or both ovaries with histologically confirmed implants, peritoneal metastasis of abdominal peritoneal surfaces, none exceeding 2 cm in diameter with or without metastasis to the retroperitoneal lymph nodes |
| T3c | IIIc | Peritoneal metastasis beyond the pelvis >2 cm in diameter with or without metastasis to the retroperitoneal lymph nodes (includes extension of tumor to capsule of liver and spleen without parenchymal involvement of either organ) |
| 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. |
| Regional lymph node involvement | ||
| Node involvement | FIGO stage | Finding |
| N0 | No lymph node involvement | |
| N0(i+) | Tumor cells are present in regional lymph node(s), no greater than 0.2 mm | |
| N1 | IIIA1 | Histologically confirmed retroperitoneal lymph nodes |
| N1a | IIIA1i | Metastasis <and= 10 mm in greatest dimension |
| N1b | IIIA1ii | Metastasis more than 10 mm in greatest dimension |
| Distant metastasis | ||
| Presence of metastasis | FIGO stage | Finding |
| M0 | No distant metastasis | |
| M1 | IV | Distant metastasis, including positive cytology of pleural effusion; liver or splenic parenchymal metastasis; metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); and transmural involvement of intestine |
| M1a | IVa | Pleural effusion with positive cytology |
| M1b | IVb | Liver or splenic parenchymal metastases; metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); transmural involvement of intestine |
- 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
- ↑ 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.