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NCCN Guidelines for Patients



Ovarian Cancer, Version 1.2017


Cancer treatments


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

other drugs.

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

fallopian tubes.




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

and BSO.

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.