Ovarian germ cell tumor staging

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2]

Overview

According to the FIGO cancer staging system, there are 4 stages of ovarian germ cell tumor.

Staging

Ovarian germ cell tumor is surgically staged using the FIGO cancer staging system.

Stage	Finding
I	Growth limited to the ovaries.
Ia	Growth limited to one ovary; no ascites present containing malignant cells. No tumor on the external surface; capsule intact.
Ib	Growth limited to both ovaries; no ascites present containing malignant cells. No tumor on the external surfaces; capsules intact.
Icb	Tumor either stage Ia or Ib, but with tumor on surface of one or both ovaries, or with capsule ruptured, or with ascites present containing malignant cells, or with positive peritoneal washings.
II	Growth involving one or both ovaries with pelvic extension.
IIa	Extension and/or metastases to the uterus and/or tubes.
IIb	Extension to other pelvic tissues.
IIcb	Tumor either stage IIa or IIb, but with 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.
III	Tumor involving one or both ovaries with histologically confirmed peritoneal implants outside the pelvis and/or positive regional lymph nodes. Superficial liver metastases equals stage III. Tumor is limited to the true pelvis, but with histologically proven malignant extension to small bowel or omentum.
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.
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.
IIIc	Peritoneal metastasis beyond the pelvis >2 cm in diameter and/or positive regional lymph nodes.
IV	Growth involving one or both ovaries with distant metastases. If pleural effusion is present, there must be positive cytology to allot a case to stage IV. Parenchymal liver metastasis equals stage IV.