Ovarian, fallopian tube and peritoneal cancer staging: Rationale and explanation of new FIGO staging 2013.

Ovarian, fallopian tube, and peritoneal cancers have a similar clinical presentation and are treated similarly, and current evidence supports staging all three cancers in a single system. The primary site (i.e., ovary, fallopian tube, or peritoneum) should be designated where possible. The histologic type should be recorded. Intraoperative rupture ("surgical spill") is IC1; capsule ruptured before surgery or tumor on ovarian or fallopian tube surface is IC2; and positive peritoneal cytology with or without rupture is IC3. The new staging includes a revision of stage III patients; assignment to stage IIIA1 is based on spread to the retroperitoneal lymph nodes without intraperitoneal dissemination. Extension of the tumor from the omentum to the spleen or liver (stage IIIC) should be differentiated from isolated parenchymal metastases (stage IVB).