Ovarian Cancer Diagnosis and Staging

Ovarian cancer diagnosis involves pelvic examination, imaging (transvaginal ultrasound as first-line, complemented by CT and MRI for staging), blood tests for tumor markers (CA-125, HE4, ROMA index), and surgical evaluation with biopsy. Definitive diagnosis requires histopathological analysis of tissue obtained during surgery, which also serves as the primary treatment for most patients.

Staging follows the FIGO system (updated 2014): Stage I is confined to the ovaries (one or both); Stage II involves one or both ovaries with pelvic extension beyond the ovaries; Stage III has spread to the peritoneum (omentum, bowel surface, liver surface) or retroperitoneal lymph nodes; Stage IV has distant metastases (pleural effusion with positive cytology, parenchymal liver or spleen metastases, or extra-abdominal spread). Most ovarian cancers are diagnosed at Stage III or IV, when the disease has already spread beyond the pelvis.

Molecular testing has become increasingly important in ovarian cancer. Key biomarkers include: BRCA1/2 mutation status (germline and somatic), homologous recombination deficiency (HRD) status, and biomarkers for targeted therapy selection (e.g., PARP inhibitor eligibility). Histological subtyping — high-grade serous (most common, ~70%), endometrioid, clear cell, mucinous, and low-grade serous — also guides treatment decisions. Cuban oncology centers utilize advanced diagnostic imaging and molecular testing for precise characterization.

Patients considering treatment in Cuba should compile their complete diagnostic dossier — including imaging reports (transvaginal ultrasound, CT, MRI), tumor marker results (CA-125 trend, HE4), biopsy/surgical pathology report with histological subtype and grade, FIGO stage, BRCA/genetic testing results if available, and prior treatment summaries — for review by the Cuban oncology team.