According to the 2014 FIGO staging for ovarian cancer, a patient is found to have bilateral ovarian serous carcinoma with tumor on the external surface of one ovary, positive cytology in peritoneal washings but no macroscopic peritoneal deposits, and negative retroperitoneal nodes. What is the correct FIGO stage?

• A Stage IC2
• B Stage IIA
• C Stage IIB
• D Stage IC3 ✓

Explanation

FIGO 2014 Stage IC is subdivided: IC1 = surgical spill; IC2 = capsule rupture before surgery or tumor on ovarian surface; IC3 = malignant cells in ascites or peritoneal washings. This patient has bilateral involvement (Stage I, not IC alone, but bilateral is still Stage I), tumor on surface = IC2, AND positive cytology = IC3. When multiple IC criteria are met, the higher sub-stage applies, so IC3. Stage IC3 is significant because positive peritoneal cytology was previously classified as Stage IIIA1 in the pre-2014 system; the 2014 reclassification to IC3 has treatment implications since adjuvant chemotherapy is routinely given for IC2 and IC3.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

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