Ovarian Involvement in Endometrial Cancer Staging

FIGO Staging Framework

The International Federation of Gynecology and Obstetrics (FIGO) 2009 staging system defines Stage IIIA as tumors invading the serosa of the corpus uteri and/or adnexa (which includes the ovaries) 1, 2, 3
Stage I is defined as tumor confined to the uterine corpus with varying degrees of myometrial invasion 1, 2
Stage II is defined as tumor invading cervical stroma but not extending beyond the uterus 1, 2
Stage IIIA is defined as tumor invading the serosa and/or adnexa (ovaries/fallopian tubes) 1, 2, 3
Stage IIIB is defined as vaginal and/or parametrial involvement 1, 2
Stage IIIC is defined as metastasis to pelvic (IIIC1) or para-aortic (IIIC2) lymph nodes 1, 2, 3

Complete surgical staging for suspected Stage IIIA disease must include total hysterectomy with bilateral salpingo-oophorectomy 4
Complete surgical staging for suspected Stage IIIA disease must include peritoneal washings/cytology 4
Complete surgical staging for suspected Stage IIIA disease must include thorough abdominal exploration 4
Complete surgical staging for suspected Stage IIIA disease must include pelvic and para-aortic lymph node assessment 3
Complete surgical staging for suspected Stage IIIA disease must include assessment of depth of myometrial invasion 2

For confirmed Stage IIIA disease with ovarian involvement, maximal surgical cytoreduction is recommended for patients with good performance status 5
For confirmed Stage IIIA disease with ovarian involvement, adjuvant chemotherapy with platinum-based regimens (carboplatin/paclitaxel or cisplatin/doxorubicin) is standard, as it significantly improves progression-free and overall survival compared to radiation alone 5, 6
For confirmed Stage IIIA disease with ovarian involvement, pelvic radiotherapy may be added to increase locoregional control 5