The course of treatment for ovarian cancer is normally determined by the stage of the disease. We here classify the stages from I to IV based on the cancer's specific characteristics, and find out which course is suitable for which stage.

By stage I, we mean the cancer is confined to a single ovary (stage IA) or both ovaries (stage IB). In stage IC, one or both ovaries can be affected, but the tumors are on the surface, or the capsule is ruptured, or tumor cells are found in abdominal fluid.

Treatment for patients with stage IA and IB includes surgical removal of the uterus and both ovaries and fallopian tubes, partial removal of the omentum, and surgical staging of the lymph nodes and other tissues in the pelvis and abdomen. Patients with stage IA or B disease may not require further therapy after surgery. Higher risk patients with stage IC are generally treated with platinum-based chemotherapy to prevent a relapse.

Stage II means the cancer has spread to the uterus or fallopian tubes (stage IIA), or other areas within the pelvis (stage IIB), but is still confined to the pelvic area. Stage IIC means capsular involvement, rupture, or positive washings. Surgical management for patients in this stage involves a total hysterectomy, bilateral salpingo-oophorectomy, and removal of as much cancer in the pelvic area as possible, known as tumor debulking. Post-surgery chemotherapy is generally needed to eliminate residual cancer and prevent relapse.

Stage III means the cancer has spread beyond the pelvis to the omentum and other areas within the abdomen, or to the lymph nodes. Most patients in this stage undergo a total hysterectomy, and tumor debulking. Here again, post-surgery chemotherapy is needed to eliminate residual cancer.

Stage IV, the most advanced of all, means the cancer may have spread to the inside of the liver or spleen. In this stage, tumor debulking before chemotherapy may be occasionally performed.

In the case of recurrent ovarian cancer, chemotherapy is the mainstay of treatment, although it might not prevent subsequent relapses.