A 62-year-old postmenopausal woman undergoes staging laparotomy for epithelial ovarian cancer. Histology reveals malignant cells in the right ovary, bilateral diaphragm, and liver surface, but no parenchymal liver involvement. What is the FIGO stage?
- A Stage IIIB
- B Stage IVA
- C Stage IIIC ✓
- D Stage IVB
Correct answer: C. Stage IIIC
Explanation
FIGO 2014 staging for ovarian cancer: Stage III = peritoneal metastases beyond the pelvis and/or retroperitoneal lymph nodes. Stage IIIC = peritoneal implants >2 cm outside the pelvis and/or regional lymph node metastasis. Liver surface (capsular) involvement is classified as Stage IIIC, not Stage IV. Stage IVA is reserved for pleural effusion with positive cytology; Stage IVB includes parenchymal liver/splenic metastases or extraabdominal metastases. Surface diaphragmatic and liver capsule implants = IIIC.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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