NCCN Guidelines for Patients
Ovarian Cancer, Version 1.2017
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.
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
lymph node dissection.
Which surgical staging procedures you will have
depends on how far your doctors think the cancer
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
A gynecologic oncologist is
a surgeon who’s an expert in
cancers that start in a woman’s