Page 4 - Ovarian cancer surgery - Guidelines (early stages)
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Appendix 1: ESGO Ovarian Cancer OPERATIVE
The Guidelines, Recommendation and Assurance Quality Committee
Hospital-Institution: City:
Identification code (for internal use only):
1. Surgery Data 2nd Surgeon Dr:
1st Surgeon Dr:
Ca-125 UI/ml at Surgery: Suspected stage IV ? If Yes, plea
Abdominal wall Liver Parenchyma Spleen Parenchyma Othe
2.Surgical Approach and Findings Approach:
Volumen of Ascites: Frozen Section: Frozen Se
Tumor inv
Right ovary Uterus Right gutter Sm
Left ovary Bladder/ ureter Left gutter Lar
Right tube Sigmoid-Rectum Small bowel Pa
Left tube Recto-vaginal septum Omentum Rig
Douglas Pelvic wall Large bowel Le
Vagina Pelvic nodes Appendix Liv
0 Central PRE
1 Right upper
2 Epigastrium
3 Left upper
4 Left flank
5 Left lower
6 Pelvis
7 Right lower
8 Right flank
9 Upper jejunum
10 Lower jejunum
11 Upper ileum
12 Lower ileum
PCI
1 PERITONEAL CANCER INDEX
