A 58-year-old postmenopausal woman has a complex ovarian mass. CA-125 is 320 U/mL. CT shows omental caking and ascites. FIGO staging is performed and she is found to have bilateral ovarian involvement with omental metastases but no peritoneal implants beyond the pelvis. Her FIGO stage is:

• A Stage IIIA1
• B Stage IIIB
• C Stage IIC
• D Stage IIIC ✓

Explanation

FIGO 2014 staging for ovarian cancer: Stage III = peritoneal spread and/or retroperitoneal lymph nodes beyond pelvis. Stage IIIC = peritoneal metastases beyond the pelvis more than 2 cm in greatest dimension, including omental involvement. Omental caking represents peritoneal metastases exceeding 2 cm, placing this patient in Stage IIIC. Stage IIIA1 is positive retroperitoneal lymph nodes only; Stage IIIB is peritoneal implants ≤2 cm. Stage IIC is confined to pelvis with malignant ascites.

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

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