Fallopian Tube Cancer Staging 

Updated: Dec 31, 2015
  • Author: from Memorial Sloan-Kettering - Elizabeth L Jewell, MD, MHSc; Chief Editor: from Memorial Sloan-Kettering - Yukio Sonoda, MD  more...
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TNM and FIGO Staging of Fallopian Tube Cancer

Because the fallopian tube is an open lumen, fallopian tube carcinoma has the ability to spread within the peritoneal cavity; consequently, surgical staging is required. [1] The TNM and International Federation of Gynecology and Obstetrics (FIGO) classifications for staging fallopian tube cancer are listed below (see Table 1) [2] ; however, modified FIGO staging (see Table 2) has been recommended as better reflecting tumor histology and patient outcome. [3]

Table 1. TNM and FIGO Staging of Fallopian Tube Cancer (Open Table in a new window)

Primary tumor (T)

TNM

FIGO

Definition

TX

 

Primary tumor cannot be assessed

T0

 

No evidence of primary tumor

Tis*

 

Carcinoma in situ (limited to tubal mucosa)

T1

I

Tumor limited to the fallopian tube(s)

T1a

IA

Tumor limited to 1 tube, without penetrating the serosal surface; no ascites

T1b

IB

Tumor limited to both tubes, without penetrating the serosal surface; no ascites

T1c

IC

Tumor limited to 1 or both tubes, with extension onto or through the tubal serosa or with malignant cells in ascites or peritoneal washings

T2

II

Tumor involves 1 or both fallopian tubes, with pelvic extensions

T2a

IIA

Extension or metastasis to the uterus or the ovaries

T2b

IIB

Extension to other pelvic structures

T2c

IIC

Pelvic extension, with malignant cells in ascites or peritoneal washings

T3

III

Tumor involves 1 or both fallopian tubes, with peritoneal implants outside the pelvis

T3a

IIIA

Microscopic peritoneal metastasis outside the pelvis

T3b

IIIB

Macroscopic peritoneal metastasis outside the pelvis ≤2 cm in greatest diameter

T3c

IIIC

Macroscopic peritoneal metastasis outside the pelvis and >2 cm in diameter

Regional lymph nodes (N)

TNM

FIGO

Definition

NX

 

Regional lymph nodes cannot be assessed

N0

 

No regional lymph node metastasis

N1

IIIC

Regional lymph node metastasis

Distant metastasis (M)

TNM

FIGO

Definition

M0

 

No distant metastasis

M1

IV

Distant metastasis (excluding metastasis with the peritoneal cavity)

* FIGO no longer considers stage 0 (Tis).

Metastasis to the liver surface (capsule) is considered T3, stage III; metastasis to the liver parenchyma is M1, stage IV. A pleural effusion with positive cytology results is M1, stage IV.

Table 2. Modified FIGO Staging of Fallopian Tube Cancer (Open Table in a new window)

Modified FIGO

Definition

I

Tumor limited to the fallopian tube(s)

IA

Tumor limited to 1 tube, without penetrating the serosal surface; no ascites

IA-0

Tumor limited to 1 tube, with no extension into the lamina propria

IA-1

Tumor limited to 1 tube, with extension into the lamina propria but no extension into the muscularis

IA-2

Tumor limited to 1 tube, with extension into the muscularis

IB

Tumor limited to both tubes, without penetrating the serosal surface; no ascites

IB-0

Tumor limited to both tubes, with no extension into the lamina propria

IB-1

Tumor limited to both tubes, with extension into the lamina propria but no extension into the muscularis

IB-2

Tumor limited to both tubes, with extension into the muscularis

IC

Tumor limited to 1 or both tubes, with extension onto or through the tubal serosa or with malignant cells in ascites or peritoneal washings

IF

Tumor limited to 1 or both tubes at the fimbriated ends, without invasion of tubal wall

II

Tumor involves 1 or both fallopian tubes, with pelvic extension

IIA

Extension or metastasis to the uterus or the ovaries

IIB

Extension to other pelvic structures

IIC

Pelvic extension, with malignant cells in ascites or peritoneal washings

III

Tumor involves 1 or both fallopian tubes, with peritoneal implants outside the pelvis; included are superficial liver implants, retroperitoneal lymph nodes, or inguinal lymph nodes

IIIA

Microscopic peritoneal metastasis outside the pelvis; negative lymph nodes

IIIB

Macroscopic peritoneal metastasis outside the pelvis ≤2 cm in greatest diameter; negative lymph nodes

IIIC

Macroscopic peritoneal metastasis outside the pelvis and >2 cm in diameter or positive retroperitoneal or inguinal lymph nodes

IV

Distant metastasis, including liver parenchyma or positive pleural cytology