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48

NCCN Guidelines for Patients

®

:

Ovarian Cancer, Version 1.2017

5

Treatment guide

Stage I ovarian cancer

Grade 1 cancer tends to grow more slowly, grade

3 tends to grow more quickly, and grade 2 is in

between. See page 30 for more details about cancer

grades.

Primary treatment options

To plan primary treatment, your doctor will first

assess the results of the prior surgery. If the prior

surgery and staging were complete, then no more

surgery is needed at this time. See

Next steps

at the

end of this section.

If surgery and staging were not complete, then more

surgery is recommended. This is to confirm the

cancer stage and, if needed, remove any remaining

cancer. The type and extent of surgery depends on

the likely cancer stage, cancer grade, and how much

(if any) cancer remains.

For ovarian cancer that is likely stage IA or IB,

grade I, surgical staging is recommended. Surgical

staging involves taking biopsy samples of the tumor

and nearby tissues to test for cancer cells. It is

done to check for cancer cells that have spread

outside the ovaries or pelvis and can only be seen

with a microscope. These are called microscopic

metastases. During surgical staging, biopsy samples

will be taken from organs and tissues where ovarian

cancer often spreads. The omentum and nearby

lymph nodes will also be removed.

For ovarian cancer that is likely stage IA or IB, grade

2, the treatment options depend on whether or not

the prior surgery removed all of the cancer. If your

doctor thinks no cancer remains, then you have

three options to choose from. The first option is to

have surgical staging alone as described above. The

second option is to have completion surgery and

surgical staging. Completion surgery removes the

remaining ovary (or ovaries), fallopian tubes, uterus,

nearby supporting tissue, the omentum, and any

cancer that can be seen.

The third option is to start treatment with

chemotherapy instead of having more surgery. If your

doctor thinks some cancer remains, then completion

surgery and surgical staging are recommended.

For ovarian cancer that is likely stage IA or IB, grade

3 or clear cell, or stage IC, the treatment options

depend on whether or not the prior surgery removed

all of the cancer. If your doctor thinks no cancer

remains, then one option is to have completion

surgery and surgical staging. Another option is to

start treatment with chemotherapy instead of having

more surgery. If your doctor thinks some cancer

remains, then completion surgery and surgical

staging are recommended.