A 55-year-old postmenopausal woman has a right ovarian mass. CA-125 is 420 U/mL. Imaging shows ascites and omental caking. After staging laparotomy, disease is found in both ovaries, the omentum, and liver surface implants but not the liver parenchyma. According to FIGO 2014 staging, she is:
- A Stage IIIC ✓
- B Stage IIIA2
- C Stage IIIB
- D Stage IVB
Correct answer: A. Stage IIIC
Explanation
FIGO 2014 Stage IIIC ovarian cancer involves peritoneal metastasis beyond the pelvis with macroscopic peritoneal implants >2 cm diameter, including omental caking, and/or retroperitoneal lymph node involvement. Liver surface implants are Stage IIIC; parenchymal liver metastasis would be Stage IVB. Omental caking with ascites also qualifies as IIIC.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
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