A patient with bilateral complex ovarian lesions has findings consistent with Stage IIIC. What stage is indicated?

• A. Stage IIIC
• B. Stage IIB
• C. Stage IV
• D. Stage IIIA

Answer: (A)

In ovarian cancer, the stage depends on how far the cancer has spread beyond the ovaries and pelvis. Stage IIIC means the cancer has spread outside the pelvis into the peritoneal cavity with implants larger than 2 cm, or there is metastasis to retroperitoneal lymph nodes. Bilateral involvement of the ovaries is compatible with advanced disease, but the defining factor is spread beyond the pelvis, which places it in IIIC. The other stages describe less extensive spread: pelvic-only extension (not beyond the pelvis), microscopic extra-pelvic metastasis, or distant metastasis beyond the peritoneal cavity. So the indicated stage is Stage IIIC.