A 55-year-old postmenopausal woman is found to have a 9 cm right ovarian mass with solid components, papillary projections, and CA-125 of 280 U/mL. Imaging shows bilateral ovarian involvement and ascites but no evidence of spread beyond pelvis. According to FIGO 2014 staging, what stage is this?

• A Stage IIA
• B Stage IIC
• C Stage IIIA1
• D Stage IIB ✓

Explanation

FIGO 2014 Stage IIB ovarian cancer is defined as tumour involving both ovaries or the fallopian tubes with pelvic extension to other pelvic intraperitoneal tissues. Since the disease is bilateral and involves the pelvis (ascites alone does not up-stage from Stage II when cytology is negative), this fits IIB. Stage IIA involves extension to uterus or tubes alone; Stage IIIA1 requires positive retroperitoneal lymph nodes; Stage IIC (old classification) no longer exists in FIGO 2014.

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

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