Approach to ovarian cancer management

CT: computed tomography.
* Adjuvant chemotherapy is administered specifically for those with stage IC or II disease, clear cell histology (any grade), or high tumor grade.
¶ Most experts agree that patients with any of the following criteria have unresectable disease:

• Diffuse and/or deep infiltration of the small bowel mesentery
• Diffuse carcinomatosis involving the stomach and/or large parts of the small or large bowel
• Infiltration of the duodenum and/or parts of the pancreas (not limited to the pancreatic tail)
• Involvement of the large vessels of the hepatoduodenal ligament, celiac trunk, or behind the porta hepatis
• Involvement of the liver parenchyma
• Lung metastases
• Lymph node metastases in axilla or mediastinum

Δ Some UpToDate experts administer 6 cycles post-surgery (rather than 3), except in verified stage I/II disease.