## Site-Specific Factor 4

### Tumor Location after Primary Cytoreduction (Debulking) Surgery

### Notes

**Note 1:** The surgery to remove as much of the cancer in the pelvis and/or abdomen as possible, reducing the "bulk" of the cancer is called "debulking" or "cytoreduction" surgery. It is performed when there is widespread evidence of advanced stage of ovarian cancer with obvious spread to other organs outside the ovary, typically in the upper abdomen, intestines, the omentum (the fat pad suspended from the transverse colon like an apron), the diaphragm, or liver. **Note 2:** Optimal debulking is described as removal of all tumor except for residual nodules that measure no more than 1 cm in maximum diameter. **Note 3:** According to the AJCC, "In advanced disease, the most important prognostic factor is the residual disease after the initial surgical management. . . . Not only is the size of the residual important, but the number of sites of residual tumor also appears to be important." Neoadjuvant chemotherapy may be given to obtain optimum cytoreduction with less aggressive surgery; thus recording whether the patient received chemotherapy prior to this procedure provides necessary data for treatment and survival analysis.### Default

988### NAACCR Item

NAACCR #2910Code | Description |
---|---|

010 | Residual tumor in ovary, ipsilateral, contralateral, or NOS AND neoadjuvant chemotherapy not given or unknown if given |

015 | 010 AND neoadjuvant chemotherapy given (before surgery) |

020 | Residual tumor in: Fallopian tube, ipsilateral, contralateral, or NOS Uterus AND neoadjuvant chemotherapy not given or unknown if given |

025 | 020 AND neoadjuvant chemotherapy given (before surgery) |

030 | 020 + 010 Residual tumor in fallopian tube(s) and/or uterus plus ovary(ies) AND neoadjuvant chemotherapy not given or unknown if given |

040 | 030 AND neoadjuvant chemotherapy given (before surgery) |

050 | Residual tumor in pelvis: Pelvic peritoneum AND neoadjuvant chemotherapy not given or unknown if given |

055 | 050 AND neoadjuvant chemotherapy given (before surgery) |

060 | 050 + (010 or 020) Residual tumor in pelvis plus any structures in lower codes AND neoadjuvant chemotherapy not given or unknown if given |

070 | 060 AND neoadjuvant chemotherapy given (before surgery) |

080 | Residual tumor in omentum AND neoadjuvant chemotherapy not given or unknown if given |

085 | 080 AND neoadjuvant chemotherapy given (before surgery) |

090 | 080 + (010 or 020 or 050) Residual tumor in omentum plus any structures in lower codes AND neoadjuvant chemotherapy not given or unknown if given |

100 | 090 AND neoadjuvant chemotherapy given (before surgery) |

110 | Residual tumor in abdomen (excluding colon and small intestine): Abdominal peritoneum Retroperitoneum AND neoadjuvant chemotherapy not given or unknown if given |

115 | 110 AND neoadjuvant chemotherapy given (before surgery) |

120 | 110 + (010 or 020 or 050 or 080) Residual tumor in abdomen plus any structures in lower codes AND neoadjuvant chemotherapy not given or unknown if given |

130 | 120 AND neoadjuvant chemotherapy given (before surgery) |

140 | Residual tumor in colon and/or small intestine AND neoadjuvant chemotherapy not given or unknown if given |

145 | 140 AND neoadjuvant chemotherapy given (before surgery) |

150 | 140 + (010 or 020 or 050 or 080 or 110) Residual tumor in colon and/or small intestine plus any structures in lower codes AND neoadjuvant chemotherapy not given or unknown if given |

160 | 150 AND neoadjuvant chemotherapy given (before surgery) |

170 | Residual tumor in diaphragm and/or stomach AND neoadjuvant chemotherapy not given or unknown if given |

180 | 170 + (010 or 020 or 050 or 080 or 110 or 140) Residual tumor in diaphragm plus any structures in lower codes AND neoadjuvant chemotherapy not given or unknown if given |

190 | 180 AND neoadjuvant chemotherapy given (before surgery) |

200 | Residual tumor in liver (peritoneal surface) AND neoadjuvant chemotherapy not given or unknown if given |

210 | 200 + (010 or 020 or 050 or 080 or 110 or 140 or 170) Residual tumor in liver plus any structures in lower codes AND neoadjuvant chemotherapy not given or unknown if given |

220 | 210 AND neoadjuvant chemotherapy given (before surgery) |

300 | Residual tumor in other structures not listed above AND neoadjuvant chemotherapy not given or unknown if given |

310 | Residual tumor in other structures not listed above AND neoadjuvant chemotherapy given (before surgery) |

988 | Not applicable: Information not collected for this case |

990 | Residual tumor, location not stated AND neoadjuvant chemotherapy not given or unknown if given |

991 | Residual tumor, location not stated AND neoadjuvant chemotherapy given (before surgery) |

992 | No residual tumor found AND neoadjuvant chemotherapy not given or unknown if given |

993 | No residual tumor found AND neoadjuvant chemotherapy given (before surgery) |

998 | No Debulking surgery performed |

999 | Unknown or no information Not documented in patient record |