NCCN Guidelines for Patients
Ovarian Cancer, Version 1.2017
Part 4 describes the main types of
treatment for ovarian cancer. This
information may help you understand the
treatment options listed in the Treatment
guide in Parts 5 and 6. It may also help
you know what to expect during treatment.
Not every person with ovarian cancer will
receive every treatment listed.
Surgery is used as the first and main (primary)
treatment for most ovarian cancers. Primary
treatment is the main treatment given to rid the
body of cancer. NCCN experts recommend that
ovarian cancer surgery should be performed by a
gynecologic oncologist. A gynecologic oncologist
is a surgeon who is an expert in cancers that start
in a woman’s reproductive organs. Gynecologic
oncologists and medical oncologists often work
closely together to plan the best treatment for ovarian
cancer. A medical oncologist is a doctor who is an
expert in treating cancer with chemotherapy and
There are two main goals of surgical treatment for
ovarian cancer. One goal is to find out how far the
cancer has spread. The other goal of surgery is to
remove all or as much of the cancer from your body
as possible. To do so, the tumor is removed along
with other organs and tissues where cancer cells
have or might have spread.
A number of procedures may be done during surgical
treatment for ovarian cancer. The type and extent of
surgery you will have depends on many factors. This
includes the tumor size, tumor location, and how far
the cancer has spread. Another key factor is whether
or not you want to be able to have babies after
Types of surgical treatment
Surgical treatment often involves removing both
ovaries, both fallopian tubes, and the uterus.
BSO (bilateral salpingo-oophorectomy)
is surgery to remove both ovaries and both
USO (unilateral salpingo-oophorectomy)
is surgery to remove only one ovary and the
attached fallopian tube.
A USO is also called “fertility-sparing surgery.” This is
because you will still be able to have babies after the
surgery if you haven’t yet gone through menopause.
A USO is only an option if the cancer is only in one
A hysterectomy is surgery to remove the uterus.
When the uterus and the cervix are removed, it is
called a total hysterectomy. Most often, the uterus
and cervix are removed through a surgical cut in
the belly (abdomen). This is called a TAH (
ysterectomy) and it is done along with a
BSO. You will not be able to have babies after a TAH
If cancer has spread outside the ovaries, then your
doctor will try to remove as much of the cancer
as possible. This is called debulking surgery or
cytoreductive surgery. During this surgery, your
doctor will attempt to remove all of the cancer that
can be seen. If the surgeon is able to remove all of
the tumors that are 1 cm or larger in size, the surgery
is called an optimal debulking. Optimal debulking is
linked with better treatment outcomes.