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NCCN Guidelines for Patients



Ovarian Cancer, Version 1.2017


Cancer staging

Surgical staging

Cancer staging is the process of finding

out how far the cancer has grown and

spread in your body. The cancer stage

is a rating of the extent of the cancer.

Doctors use cancer staging to plan

which treatments are best for you. Part 3

describes the staging process and defines

the stages of ovarian cancer.

Surgical staging

Cancer is often staged twice. The clinical stage

is based on tests done before surgery. It can give

your doctors an idea of how far the cancer may

have spread. But, to know the true extent of ovarian

cancer, surgery is needed. The pathologic stage is

based on the results of surgery and tests of tissue

removed during surgery. It is the most important

stage and is used to plan treatment.

During surgery to remove the cancer, your doctor will

perform a number of tests to find out exactly how far

it has spread. This is called surgical staging. It is the

most complete and accurate way to stage ovarian


During surgical staging, your doctor will carefully

inspect tissues and organs near the tumor to see

where the cancer has spread.

Some tissues will be removed so they can be tested

for cancer cells. This includes removing some or all

of the omentum and nearby lymph nodes.



Surgery to remove the omentum is called an




Surgery to remove nearby lymph nodes is

called a

lymph node dissection.

Which surgical staging procedures you will have

depends on how far your doctors think the cancer

has spread.

Your doctor will also take biopsy samples from

nearby tissues where it looks like the cancer hasn’t

spread. This is done to check for cancer cells that

have spread but can only be seen with a microscope.

These are called microscopic metastases. Your

doctor will take samples from places where ovarian

cancer often spreads.

See Figure 7

on the next



What to know...


NCCN experts recommend that

surgical staging be done by a

gynecologic oncologist.


A gynecologic oncologist is

a surgeon who’s an expert in

cancers that start in a woman’s

reproductive organs.