NCCN Guidelines for Patients® | Ovarian Cancer - page 23

Part 3: Treatment planning
NCCN Guidelines for Patients
: Ovarian cancer
Version 1.2013
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Identification of
a disease
Gynecologic oncologist:
A doctor who’s an expert
in treating cancer that
starts in the female organs
involved in making babies
The organs that
food travels through after
leaving the stomach
A tool that
uses lenses to see things
the eyes can’t
A doctor
who’s an expert in testing
cells and tissue to find
Primary tumor:
The first
mass of cancer cells in
the body
Surgical staging procedures
During surgery, your doctor will carefully inspect tissues and organs near the
tumor to see if and where the cancer has spread. Surgical staging involves
removing tissue near the tumor, where it looks like the cancer hasn’t spread, so
it can be tested for cancer cells. This is done to check for cancer cells that have
spread outside of the ovaries and can only be seen with a microscope. These
are called microscopic metastases. Which surgical staging procedures you will
have depends on how far your doctor thinks the cancer may have spread in
your body.
Omentectomy and lymph node dissection are two procedures that are used
for surgical staging. An omentectomy is surgery to remove the omentum. The
omentum is a layer of fatty tissue covering the intestines and organs in the
abdomen. Lymph node dissection is surgery to remove lymph nodes from the
area near the tumor.
In addition to the tumor, surgical staging also involves taking biopsy samples
from other nearby tissues and organs where ovarian cancer often spreads. See
Figure 6. The number of biopsy samples removed and where they are removed
from depends on how far your doctor thinks the cancer has spread. Biopsy
samples may be taken from the:
• Nearby lymph nodes (groups of special disease-fighting cells),
• Pelvis (area between the hip bones),
• Abdomen (belly area between the chest and pelvis),
• Diaphragm (muscles below the ribs that help a person breathe),
• Omentum (layer of fatty tissue covering organs in the abdomen),
• Peritoneum (tissue lining the inside of the abdomen), and
• Ascites (abnormal fluid buildup in the abdomen).
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