Stages and grades
The stage of a cancer tells you how big it is and if it has spread. The tests and scans you have to diagnose your cancer will give some information about the stage. But your doctor might not be able to tell you the exact stage until you have surgery.
Doctors use the International Federation of Gynecology and Obstetrics (FIGO) staging system to stage cancers in the:
ovaries
fallopian tubes
peritoneum
There are four stages, numbered 1 to 4.
Stage 3 ovarian cancer has spread outside the into the abdominal cavity or to lymph nodes. Treatment includes surgery and chemotherapy.
Staging can be complicated. Talk to your specialist doctor or nurse if you are unsure. They can help you understand more about your cancer stage.
Read more about the stages and grades of ovarian cancer
Stage 3 ovarian cancer is in lining of your abdominal cavity (peritoneum). Or it might have spread to the in the back of your tummy (abdomen).
There are three groups - 3A, 3B and 3C:
Stage 3A has 2 groups:
Stage 3A1 means the cancer has spread to the lymph nodes in the back of your abdomen (retroperitoneal lymph nodes). This is split into 2:
3A1(i) means the cancer in the lymph nodes is smaller than 1cm
3A1(ii) means the cancer in the lymph nodes is larger than 1cm
Stage 3A2 means that there are cancer cells in the peritoneum. It might also be in your lymph nodes
Stage 3B means there are cancer growths in the peritoneum that are 2cm or smaller. There might also be cancer in the retroperitoneal lymph nodes.
Stage 3C means there are cancer growths in the peritoneum larger than 2cm. There might also be cancer in your lymph nodes or on the surface of your spleen or liver.
Treatments for stage 3 ovarian cancer include:
surgery
chemotherapy
Your healthcare team consider several factors when deciding what treatment you need. These include;
where the cancer has spread to
whether the specialist surgeon (gynaecological oncologist) thinks they can remove all the cancer
your general health
Your specialist surgeon (gynaecological oncologist) will remove:
both ovaries
fallopian tubes
your womb (including the cervix)
They will also check where the cancer has spread to in your pelvis and if it is in your lymph nodes. Your gynaecological oncologist will aim to remove as much of the cancer as possible.
This is called cytoreductive surgery. You may also hear it called debulking surgery.
You might have:
chemotherapy after surgery – this is called adjuvant chemotherapy with cytoreductive surgery
chemotherapy before and after surgery – this is called neoadjuvant chemotherapy with interval cytoreductive surgery
chemotherapy into your abdomen during surgery – this is called hyperthermic intraperitoneal chemotherapy or HIPEC
Your healthcare team will discuss the best treatment for you. When you have chemotherapy will depend on your individual case.
Some people may have treatment with a targeted cancer drug. This will depend on your situation. You might have a targeted cancer drug:
with chemotherapy
on its own after chemotherapy
It might not be possible to have surgery if your cancer has spread widely or you are not well enough.
You can have chemotherapy on its own to shrink the cancer as much as possible and to slow it down.
You might have other treatments to help relieve your symptoms. This could be treatment for fluid in the abdomen (ascites) or for a blocked bowel. Or radiotherapy to relieve symptoms like pain.
Read more about ovarian cancer treatment
Researchers are always trying to improve the treatment and quality of life for people with ovarian cancer.
Find out more about research into ovarian cancer
Last reviewed: 17 Feb 2025
Next review due: 17 Feb 2028
Ovarian cancer is when abnormal cells in the ovary grow and divide in an uncontrolled way.
The symptoms of ovarian cancer can include a swollen or painful tummy, loss of appetite or urinary changes.
Most ovarian cancers start in the cells covering the ovaries and are called epithelial ovarian cancers. Other rare types include germ cell tumours, stromal tumours and sarcomas.
There is support available to help you cope with a diagnosis of ovarian cancer, life during treatment and life after cancer.
The main treatments for ovarian cancer are surgery and chemotherapy. Your treatment depends on several factors including your cancer stage and grade.
Ovarian cancer is when abnormal cells in the ovary, fallopian tube or peritoneum begin to grow and divide in an uncontrolled way.
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