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NCCN Guidelines for Patients



Ovarian Cancer, Version 1.2017


Treatment guide

Low-grade serous/endometrioid epithelial

Guide 15

starts with more tests used to further

diagnose mucinous carcinoma of the ovary. The

GI tests and CEA blood test help doctors assess if

the cancer started in the GI area and spread to the

ovaries (metastatic cancer), or if the cancer started in

the ovaries (primary cancer). Surgical staging is also

done and gives more information about the extent of

the cancer.

An appendectomy is also recommended during

surgery for those with a mucinous carcinoma of

the ovary. An appendectomy is the removal of the

appendix. This organ is found at the beginning of the

large intestine. It is located in the lower right side of

your abdomen.

Once surgery is complete and the stage is known,

adjuvant treatment may be offered. This includes

observation, chemotherapy, and if not done before

for stage IC, fertility-sparing surgery. Observation is

an option for early-stage disease.

For stage IC, adjuvant treatment options are

observation, IV carboplatin with either paclitaxel

or docetaxel, 5-FU, leucovorin and oxaliplatin, or

capecitabine/oxaliplatin. For stages II to IV adjuvant

treatment may include chemotherapy (same given

for epithelial ovarian cancer), 5-FU, leucovorin, and

oxaliplatin, or capecitabine and oxaliplatin.

Some doctors think that the combinations of 5-FU,

leucovorin, and oxaliplatin and capecitabine and

oxaliplatin are helpful because these mucinous

tumors are similar to GI tumors. Treatment

for GI cancer includes those combinations of


Low-grade (grade 1) serous/

endometrioid epithelial


Serous and endometrioid are less common subtypes

of epithelial ovarian cancer. Low-grade serous

epithelial cancer is a slow-growing (indolent) cancer

found at a younger age than those with a high-grade

serous epithelial ovarian cancer.

Endometrioid epithelial carcinoma may be related to

endometriosis. Endometriosis is a medical condition

where tissue inside the uterus grows out into other

nearby tissue or organs like the ovaries and fallopian

tubes. When examined, endometrioid tumors look

similar to malignant sex cord-stromal tumors. (See

page 74 for more information on malignant sex-cord

stromal tumors.)

Primary treatment includes completion surgery with

surgical staging followed by adjuvant treatment.

Most people are diagnosed with low-grade serous/

endometrioid epithelial carcinoma after surgery.