Site-Specific Factor 3

Residual Tumor Status and Size After Primary Cytoreduction Surgery

Notes

**Note 1:** The surgery to remove as much cancer in the pelvis and/or abdomen as possible, reducing the "bulk" of the cancer, is called "debulking" or "cytoreductive" 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 centimeter (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." Neoadjuvant chemotherapy may be given to obtain optimum cytoreduction with less aggressive surgery; recording whether the patient received chemotherapy prior to this procedure provides necessary data for treatment and survival analysis. (1) **Note 4:** Record the largest residual tumor nodule(s) remaining after primary cytoreductive surgery, as described by the surgeon in the operative report.

Default

999

NAACCR Item

NAACCR #2900

Metadata

None
Code Description
000 No gross residual tumor nodules
010 Residual tumor nodule(s) 1 centimeter (cm) or less
AND neoadjuvant chemotherapy not given or unknown if given
020 Residual tumor nodule(s) 1 cm or less
AND neoadjuvant chemotherapy given (before surgery)
030 Residual tumor nodule(s) greater than 1 cm
AND neoadjuvant chemotherapy not given or unknown if given
040 Residual tumor nodule(s) greater than 1 cm
AND neoadjuvant chemotherapy given (before surgery)
988 Not applicable: Information not collected for this case
990 Macroscopic residual tumor, size not stated
AND neoadjuvant chemotherapy not given or unknown if given
991 Macroscopic residual tumor nodule(s), size not stated
AND neoadjuvantchemotherapy given (before surgery)
992 Procedure described as optimal debulking and size of residual tumor nodule(s) not given
AND neoadjuvant chemotherapy not given or unknown if given
993 Procedure described as optimal debulking and size of residual tumor nodule(s) not given
AND neoadjuvant chemotherapy given (before surgery)
998 No cytoreductive surgery performed
999 Unknown or no information
Not documented in patient record
(1) American Joint Committee on Cancer., & Edge, S.B. (2010) AJCC Cancer Staging Manual (7th ed.). New York; London: Springer, pg. 420