According to FIGO staging, which stage of ovarian cancer is defined by tumor limited to one ovary with intact capsule and no ascites?

Explanation

## FIGO Staging of Ovarian Cancer (2014 Revision) **Key Point:** FIGO Stage IA represents the earliest stage of ovarian cancer with the best prognosis, defined by tumor confined to a single ovary with an intact capsule and absence of ascites. ### Stage I Substages | Stage | Criteria | Prognosis | |-------|----------|----------| | **IA** | Tumor limited to **one ovary**; intact capsule; **no ascites** | Excellent (>90% 5-year OS) | | **IB** | Tumor in **both ovaries**; otherwise same as IA | Good (85–90% 5-year OS) | | **IC** | Stage IA or IB **with rupture of capsule**, surface involvement, **positive peritoneal cytology**, or **ascites** | Intermediate (70–80% 5-year OS) | ### Key Distinctions in Stage I **High-Yield:** The presence of **ascites** or **capsular rupture** upgrades a Stage I tumor to Stage IC, which significantly impacts prognosis and treatment recommendations. **Mnemonic:** **"One = IA, Both = IB, Capsule/Cytology/Ascites = IC"** — helps recall the substage criteria. ### Clinical Implications - **Stage IA:** Surgery alone (total abdominal hysterectomy + bilateral salpingo-oophorectomy + staging) may be sufficient in selected young patients with low-grade tumors; adjuvant chemotherapy often omitted in early-stage, low-risk disease - **Stage IB:** Adjuvant chemotherapy typically recommended - **Stage IC:** Adjuvant chemotherapy (platinum-based) is standard of care **Clinical Pearl:** Careful surgical staging is critical in early-stage ovarian cancer. Intraoperative rupture of the capsule (even if unintentional) upstages the patient and mandates adjuvant chemotherapy. **Warning:** Do not confuse FIGO staging with tumor grade (G1, G2, G3). Grade and stage are independent prognostic factors; a Stage IA, Grade 3 tumor has worse prognosis than Stage IA, Grade 1.