Fallopian Tube Cancer Staging

Updated: Jul 11, 2023
Author: Elizabeth L Jewell, MD, MHSc, FACOG, FACS; Chief Editor: Yukio Sonoda, MD 

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 tumor-node-metastasis (TNM) classification of the American Joint Committee on Cancer (AJCC) and the International Federation of Gynecology and Obstetrics (FIGO) classification for staging fallopian tube cancer are listed below (see Table 1), as well as the AJCC prognostic groups (see Table 2).[1, 2, 3, 4]

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

T1

I

Tumor limited to the fallopian tube(s)

T1a

IA

Tumor limited to 1 tube; no tumor on tube surface; no malignant cells in ascites or peritoneal washings

T1b

IB

Tumor limited to both tubes; no tumor on tube surface; no malignant cells in ascites or peritoneal washings

T1c

IC

Tumor limited to 1 or both tubes, with any of the following:

T1c1

IC1

Surgical spill

T1c2

IC2

Capsule ruptured before surgery or tumor on tube surface

T1c3

IC3

Malignant cells in ascites or peritoneal washings

T2

II

Tumor involves 1 or both fallopian tubes, with pelvic extension below pelvic brim or primary peritoneal cancer

T2a

IIA

Extension to and/or implants on the uterus or the ovaries

T2b

IIB

Extension to and/or implants on other pelvic tissues

T3

III

Tumor involves 1 or both fallopian tubes, or primary peritoneal cancer, with microscopically confirmed peritoneal metastasis outside the pelvis and/or metastasis to the retroperitoneal (pelvic and/or para-aortic) lymph nodes

T3a

IIIA

Microscopic extrapelvic (above the pelvic brim) peritoneal involvement with or without positive retroperitoneal lymph nodes

T3b

IIIB

Macroscopic peritoneal metastasis beyond the pelvis ≤2 cm in greatest diameter, with or without positive retroperitoneal lymph nodes

T3c

IIIC

Macroscopic peritoneal metastasis outside the pelvis and > 2 cm in diameter, with or without positive retroperitoneal lymph nodes (includes extension of tumor to capsule, but not parenchyma, of liver and spleen)

Regional lymph nodes (N)

TNM

FIGO

Definition

NX

 

Regional lymph nodes cannot be assessed

N0

 

No regional lymph node metastasis

N0(i+)

 

Isolated tumor cells in regional lymph node(s) ≤0.2 mm

N1

IIIA1

Positive retroperitoneal lymph nodes only (histologically confirmed)

N1a

IIIA2

Metastasis ≤10 mm in greatest dimension

N1b

IIIA3

Metastasis > 10 mm in greatest dimension

Distant metastasis (M)

TNM

FIGO

Definition

M0

 

No distant metastasis

M1

IV

Distant metastasis, including pleural effusion with positive cytology; liver or splenic parenchymal metastasis; metastasis to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); and transmural involvement of intestine

M1a

IVA

Pleural effusion with positive cytolog

M1b

IVB

Liver or splenic parenchymal metastases; metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside the abdominal cavity); transmural involvement of intestine

Table 2. AJCC Prognostic Groups of Fallopian Tube Cancer (Open Table in a new window)

Stage

T

N

M

I

T1

N0

M0

IA

T1a

N0

M0

IB

T1b

N0

M0

IC

T1c

N0

M0

II

T2

N0

M0

IIA

T2a

N0

M0

IIB

T2b

N0

M0

IIIA1

T1/T2

N0

M0

IIIA2

T3a

NX/N0/N1

M0

IIIB

T3b

NX/N0/N1

M0

IIIC

T3c

NX/N0/N1

M0

IV

Any T

Any N

M1

IVA

Any T

Any N

M1a

IVB

Any T

Any N

M1b