Cancer of the ovary, fallopian tube, and peritoneum

Abstract

The Gynecologic Oncology Committee of FIGO in 2014 revised the staging of ovarian cancer, incorporating ovarian, fallopian tube, and peritoneal cancer into the same system. Most of these malignancies are high‐grade serous carcinomas (HGSC). Stage IC is now divided into three categories: IC1 (surgical spill); IC2 (capsule ruptured before surgery or tumor on ovarian or fallopian tube surface); and IC3 (malignant cells in the ascites or peritoneal washings). The updated staging includes a revision of Stage IIIC based on spread to the retroperitoneal lymph nodes alone without intraperitoneal dissemination. This category is now subdivided into IIIA1(i) (metastasis ≤10 mm in greatest dimension), and IIIA1(ii) (metastasis >10 mm in greatest dimension). Stage IIIA2 is now “microscopic extrapelvic peritoneal involvement with or without positive retroperitoneal lymph node” metastasis. This review summarizes the genetics, surgical management, chemotherapy, and targeted therapies for epithelial cancers, and the treatment of ovarian germ cell and stromal malignancies.

Pre-operative assessment of intra-abdominal disease spread in epithelial ovarian cancer: a comparative study between ultrasound and computed tomography

“…International Federation of Gynecology and Obstetrics (FIGO) classification was used for staging the tumors 2. Complete cytoreduction (R0) was defined as no macroscopic residual disease.…”

“…Approximately 70% of women with epithelial ovarian cancer present with advanced stage at diagnosis 2. The current standard treatment for ovarian cancer includes surgery for staging and/or debulking followed by taxane/platimum-based chemotherapy 3…”

Relevance of enlarged cardiophrenic lymph nodes in determining prognosis of patients with advanced ovarian cancer

“…This includes pleural effusion with positive cytology (stage IVA), lung parenchymal metastases and metastases to extra-abdominal organs including inguinal lymph nodes and lymph nodes outside of the abdominal cavity (stage IVB) 7. These extra-abdominal metastases are found to be present in 12%–33% of the patients at initial diagnosis 8.…”

ecancermedicalscience

“…Depending on their size, BOTs are classified according to the FIGO classification used for other ovarian tumours [9]; however, the majority of these tumours (70–80%) are diagnosed at stage I, compared with 25% of carcinomas [3]. A diagnosis of BOT in stages II and III is rare, and exceptional in stage IV [1, 7, 10].…”

“…In addition, cystectomy, which produces an increased risk of recurrence on the ipsilateral ovary (31%) [9], should be carried out only on women with bilateral tumours, with only one ovary, or on those patients who are extremely young, such that a loss of a large mass of ovarian tissue might negatively affect their fertility later on (though recent studies have obtained excellent fertility results in patients treated with unilateral salpingo-oophorectomy) [3, 7, 12, 17]. The increased relapse rate after cystectomy may be caused by: intraoperative cyst rupture, the presence of a multifocal BOT, or tumour margins affected after the cystectomy [1, 8].…”