The Gynecologic Oncology Committee of FIGO in 2014 revised the staging of ovarian
cancer, incorporating ovarian, fallopian tube, and peritoneal cancer into the same
system.
Most of these malignancies are high-grade
serous carcinomas (HGSC). Stage IC
is now divided into three categories: IC1 (surgical spill); IC2 (capsule ruptured before
surgery or tumor on ovarian or fallopian tube surface); and IC3 (malignant cells in the
ascites or peritoneal washings). The updated staging includes a revision of Stage IIIC
based on spread to the retroperitoneal lymph nodes alone without intraperitoneal
dissemination.
This category is now subdivided into IIIA1(i) (metastasis ≤10 mm in
greatest dimension), and IIIA1(ii) (metastasis >10 mm in greatest dimension). Stage IIIA2
is now “microscopic extrapelvic peritoneal involvement with or without positive
retroperitoneal
lymph node” metastasis. This review summarizes the genetics, surgical
management, chemotherapy, and targeted therapies for epithelial cancers, and the
treatment of ovarian germ cell and stromal malignancies.