Stage II - Growth of tumor in one or both ovaries
Stage III - Tumor involving one or both ovaries with peritoneal implants outside the pelvis and/or positive retroperitoneal or inguinal lymph nodes. Superficial liver metastasis equals stage III.
Stage IV - Growth involving one or both ovaries with distant metastases. If pleural effusion is present there must be positive cytology to allot a case to stage IV. Tumor spread inside the liver, equals stage IV.
Recurrent/Refractory - Recurrence means that the tumor has returned after initial therapy. Refractory means that the tumor fails to respond to initial treatment.