Carcinoma Ovary

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  Stage I – limited to one or both ovaries
  
  
  
  
  
  • IA – involves one ovary; capsule intact; no tumor on ovarian surface; no malignant cells in ascites or peritoneal washings
    
  
  
  • IB – involves both ovaries; capsule intact; no tumor on ovarian surface; negative washings
    
  
  
  • IC – tumor limited to ovaries with any of the following: capsule ruptured, tumor on ovarian surface, positive washings
    
  
  
  
  


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  Stage II – pelvic extension or implants
  
  
  
  
  
  • IIA – extension or implants onto uterus or fallopian tube; negative washings
    
  
  
  • IIB – extension or implants onto other pelvic structures; negative washings
    
  
  
  • IIC – pelvic extension or implants with positive peritoneal washings
    
  
  
  
  


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  Stage III – microscopic peritoneal implants outside of the pelvis; or limited to the pelvis with extension to the small bowel or omentum
  
  
  
  
  
  • IIIA – microscopic peritoneal metastases beyond pelvis
    
  
  
  • IIIB – macroscopic peritoneal metastases beyond pelvis less than 2 cm in size
    
  
  
  • IIIC – peritoneal metastases beyond pelvis > 2 cm or lymph node metastases
    
  
  
  
  


• Stage IV – distant metastases to the liver or outside the peritoneal cavity
  

Para-aortic lymph node metastases are considered regional lymph nodes (Stage IIIC).


Key Points:4 stages, First 3 stages have subdivisions A,B,C.IVth stage has no sudivisions.


Treatment


TAH+BSO+OMENTECTOMY


Postoperative chemotherapy


Neoadjuvant chemo


Radiotherapy


Immunotherapy.

Related articles

• Genetic associations of some carcinomas

Carcinoma Endometrium

Stage I-Tumour limited to uterine corpus

• Stage IA: tumor limited to the endometrium
  


• Stage IB: invasion of less than half the myometrium
  


• Stage IC: invasion of more than half the myometrium
  

Stage II-Tumour confined to uterus and cervix

• Stage IIA: endocervical glandular involvement only
  


• Stage IIB: cervical stromal invasion
  

Stage III-Local spread confined to the pelvis

• Stage IIIA: tumor invades serosa or adnexa, or malignant peritoneal cytology
  


• Stage IIIB: vaginal metastasis
  


• Stage IIIC: metastasis to pelvic or para-aortic lymph nodes
  

Stage IV-Distant spread/organ invasion

• Stage IVA: invasion of the bladder or bowel
  


• Stage IVB: distant metastasis, including intraabdominal or inguinal lymph nodes
  

Key Points:

• 4 stages Stage I and III has 3 subdivisions A,B,C.
  


• LN spread mentioned only in STAGE III AND IV
  

Treatment :


Stage I and II-TAH+BSO,stage II may also need adjuvant radiotherapy


Stage III and IV-TAH+BSO+postoperative radiotherapy

Carcinoma Cervix

The TNM staging system for cervical cancer is analogous to the FIGO stage.

• Stage 0 – full-thickness involvement of the epithelium without invasion into the stroma (carcinoma in situ)
  


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  Stage I – limited to the cervix
  
  
  
  
  
  • 
    
    IA – diagnosed only by microscopy; no visible lesions
    
    
    
    
    
    • IA1 – stromal invasion less than 3 mm in depth and 7 mm or less in horizontal spread
      
    
    
    • IA2 – stromal invasion between 3 and 5 mm with horizontal spread of 7 mm or less
      
    
    
    
    
  
  
  • 
    
    IB – visible lesion or a microscopic lesion with more than 5 mm of depth or horizontal spread of more than 7 mm
    
    
    
    
    
    • IB1 – visible lesion 4 cm or less in greatest dimension
      
    
    
    • IB2 – visible lesion more than 4 cm
      
    
    
    
    
  
  
  
  


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  Stage II – invades beyond cervix
  
  
  
  
  
  • IIA – without parametrial invasion, but involve upper 2/3 of vagina
    
  
  
  • IIB – with parametrial invasion
    
  
  
  
  


• 
  
  Stage III – extends to pelvic wall or lower third of the vagina
  
  
  
  
  
  • IIIA – involves lower third of vagina
    
  
  
  • IIIB – extends to pelvic wall and/or causes hydronephrosis or non-functioning kidney
    
  
  
  
  

Stage IV-Distant spread

• IVA – invades mucosa of bladder or rectum and/or extends beyond true pelvis
  


• IVB – distant metastasis
  

Key Points:4stages, each having two subdivisions A and B.No mention of LN status,Ascites.


Treatment


Tumour <5mm-Conization(to preserve fertility)or hysterectomy


Invasive lesions not extending to abdominal viscera or distal vagina-Hysterectomy+Chemotherapy+Radiotherapy


Recurrent disease- Radiotherapy.

Related articles

• Cancer of the Cervix