Epithelial ovarian cancer: FIGO 2021 staging, histotypes and the PARP era

A 64-year-old presents with three months of bloating, early satiety and a pelvic mass on examination. CA-125 is 480. CT shows omental cake, peritoneal deposits and ascites. This is ovarian cancer until proven otherwise, and the next questions — fit for primary surgery? BRCA mutation? HRD positive? — drive everything that follows. This topic turns a CT scan into a defensible plan.^[1][12]

Overview and definition

Epithelial ovarian cancer (EOC) is the malignant surface-epithelial tumour of the ovary, fallopian tube or peritoneum. FIGO unified ovarian, fallopian tube and primary peritoneal cancer into one staging system in 2014; the 2021 update (Berek et al.) carries that staging through. Because as many as 80 percent of tumours previously classified as high-grade serous carcinoma of the ovary or peritoneum may have originated in the fimbrial end of the fallopian tube, the disease is increasingly reframed as tubo-ovarian cancer.^[1][9]

About two-thirds of all epithelial ovarian cancers are Stage III or Stage IV at diagnosis. The largest number of patients is in the 60 to 64 years age group, and the lifetime risk of a woman in the USA developing ovarian cancer is approximately 1 in 70.^[1]

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References14ShowHide

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