This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Gynaecological oncology, Subject name: Gynaecology & Obstetrics
70yrs old patient diagnosed with ovarian cancer. Surgical staging involving inguinal lymph nodes 
Select and explain. 
A. Stage IIIA, B. Stage IIIB, C. Stage IVA, D. Stage IV B
D: Stage IV B
Answer: D: Stage IV B 
Explanation: Stage IV: distant metastasis excluding peritoneal metastasis. IVA: pleural effusion with positive cytology. IVB: hepatic and/ or splenic parenchyma metastasis, metastasis to extra abdominal organs (including inguinal lymph nodes and lymph nodes outside of the abdominal cavity) Reference: textbook of gynaecology Sheila balakrishnan, 2nd edition, pg no:277 <\p>