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Cancer of the ovary, fallopian tube, and peritoneum: Staging and initial surgical management

Author
Heidi J Gray, MD
Section Editors
Barbara Goff, MD
Rochelle L Garcia, MD
Deputy Editor
Sandy J Falk, MD, FACOG

INTRODUCTION

Cancer of the ovary, fallopian tube, or peritoneum often requires surgery for diagnosis. In addition, the staging and initial management of women with cancer at these sites is surgical. Optimal surgical cytoreduction is associated with improved survival.

Staging and initial surgical management should be performed by a gynecologic oncologist whenever possible. Outcomes of these procedures when performed by a gynecologic oncologist have been shown to be better than when the procedure is performed by other surgeons. (See "Management of an adnexal mass", section on 'Referral to a specialist'.)

High-grade serous epithelial ovarian, fallopian tubal, and peritoneal carcinomas are considered a single clinical entity due to their shared clinical behavior and treatment. There is accumulating evidence of a common pathogenesis for these carcinomas. In this topic, we will sometimes refer to all of these entities together as epithelial ovarian carcinoma (EOC). Distinctions between these conditions, where present, will be addressed. (See "Pathogenesis of ovarian, fallopian tubal, and peritoneal serous carcinomas".)

Staging and surgical management of women with EOC will be reviewed here. Management of an adnexal mass, diagnosis of, and chemotherapy for these cancers are discussed separately. (See "Management of an adnexal mass" and "Neoadjuvant chemotherapy for newly diagnosed advanced ovarian cancer" and "Adjuvant therapy of early stage (stage I and II) epithelial ovarian, fallopian tubal, or peritoneal cancer" and "Epithelial carcinoma of the ovary, fallopian tube, and peritoneum: Clinical features and diagnosis" and "First-line chemotherapy for advanced (stage III or IV) epithelial ovarian, fallopian tubal, and peritoneal cancer".)

PREOPERATIVE EVALUATION

Issues specific to the preoperative evaluation of women with suspected ovarian, fallopian tubal, or peritoneal cancer are discussed here. General principles of the preoperative evaluation of patients for gynecologic surgery are discussed separately. (See "Overview of preoperative evaluation and preparation for gynecologic surgery".)

                                         

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Literature review current through: Nov 2016. | This topic last updated: Tue Nov 22 00:00:00 GMT+00:00 2016.
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