Collaborative Stage

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.

Code	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)
888	OBSOLETE DATA CONVERTED V0200 See code 988 Not applicable for this site
988	Not applicable: Information not collected for this case (May include cases converted from code 888 used in CSv1 for "Not applicable" or when the item was not collected. If this item is required to derive T, N, M, or any stage, use of code 988 may result in an error.)
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

Ovary

CS Site-Specific Factor 4
Tumor Location after Primary Cytoreduction (Debulking) Surgery

Ovary

CS Site-Specific Factor 4Tumor Location after Primary Cytoreduction (Debulking) Surgery

CS Site-Specific Factor 4
Tumor Location after Primary Cytoreduction (Debulking) Surgery