Page 27 - Ovarian Cancer Surgery - Quality Indicators
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5.6 QI 6 - Required preoperative workup
5.6.1 Description of the QI
TYPE Process indicator.
DESCRIPTION Unresectable parenchymal metastases have been ruled out by imaging. Ovarian and
peritoneal malignancy secondary to gastrointestinal cancer has been ruled out by suitable
methods e.g. plasma CA 125 and CEA levels, and/or by biopsy under radiologic or
laparoscopic guidance.
SPECIFICATIONS Numerator: number of patients with advanced ovarian cancer who had undergone
cytoreductive surgery and who were offered minimum preoperative workup as defined
above.
Denominator: all patients with suspected advanced ovarian cancer who underwent
cytoreductive surgery.
TARGETS ≥ 95%
SCORING RULE 3 if the target is met.
5.6.2 Rationale
An accurate diagnosis guides patient management and informs prognosis. It is crucial to determine whether
peritoneal infiltration and/or omental masses in patients with prior malignancy represent recurrent disease or a
new disease process258. A great proportion of women with newly diagnosed ovarian cancer have peritoneal
carcinomatosis. Ovarian and peritoneal malignancy secondary to gastrointestinal cancer has to be ruled out by
suitable methods. In case of possible gastro-intestinal tract origin, colonoscopy and gastroscopy should be
performed before surgery. Furthermore, parenchymal metastases have to be ruled out by imaging. One previous
initiative53 published a QI for this topic.
5.6.3 Summary of available scientific evidence
No directly applicable clinical studies have been identified.
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