10
Figure 2. Staging and Surgery Recommendations by Resource
Level (cont'd)
Basic
Limited
Enhanced
Evaluated
for surgical
management
taking into
account
tumor
burden,
functional
status
assessment
(FSA),
comorbidity
Complete tumor
cytoreduction to
no gross residual
disease/remove
all macroscopic
visible disease OR
refer to higher-
level cancer
center
Counsel
patients on
treatment
options and
refer them
to a cancer
treatment
center with
specialized
surgical
services
Complete
tumor
cytoreduction
to no gross
residual
disease/
remove all
macroscopic
visible disease
If unable to travel
to a distant health
center, refer to
palliative care
recommendations
If performed with
currative intent,
maximal effort
cytoreductive
surgery with the
aim to remove all
intra-abdominal
macroscopic
tumor
Interval
debulking is not
recommended
a
NACT and
interval
debulking in
FIGO stage
IIIC or IV, in
expectantly
high morbidity
surgery and
patients with
poor PS or
unresectable
disease
NACT and interval
debulking in
International
Federation of
Gynecology and
Obstetrics (FIGO) stage
IIIC or IV, in expectantly
high morbidity surgery
and patients with poor
performance status (PS)
or unresectable disease
OR refer to higher-level
cancer center
Basic setting
recommendations
Basic setting
recommendation
Surgery for Stage III/IV
a
Due to current gaps in health system and human resource availability.
Staging and Surgery
