Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The calculator in question is the FIGO (International Federation of Gynecology and Obstetrics) staging system for ovarian cancer. This system is specifically used for patients diagnosed with ovarian cancer. The FIGO staging system is a clinical tool that helps in determining the extent or progression of ovarian cancer in a patient. It is crucial for guiding treatment decisions and providing prognostic information. The stages range from Stage I (cancer is confined to the ovaries or fallopian tubes) to Stage IV (cancer has spread to distant sites beyond the pelvis). 

The FIGO staging system is not applicable to patients without a confirmed diagnosis of ovarian cancer. It also may not be accurate in patients who have not undergone appropriate surgical staging procedures, as the staging often depends on surgical findings.

FIGO staging for ovarian cancer

# Criteria
 ## Criteria
A. Tumor limited to 1 ovary, no tumor on ovarian surface, no malignant cells in the ascites or peritoneal washings
B. Tumor limited to both ovaries, no tumor on ovarian surface, no malignant cells in the ascites or peritoneal washings 
C. Tumor limited to 1 or both ovaries with surgical spill intraoperatively
D. Tumor limited to 1 or both ovaries with capsule rupture before surgery or tumor on ovarian surface
E. Tumor limited to 1 or both ovaries with malignant cells in the ascites or peritoneal washings
F. Tumor involves 1 or both ovaries with pelvic extension and/or implants on the uterus and/or fallopian tubes and/or ovaries
G. Tumor involves 1 or both ovaries with pelvic extension to other pelvic intraperitoneal tissues
H. Tumor involves 1 or both ovaries with cytologically or histologically confirmed spread to the peritoneum outside the pelvis and/or metastasis to the retroperitoneal lymph nodes <= 10 mm in greatest dimension 
I. Tumor involves 1 or both ovaries with cytologically or histologically confirmed spread to the peritoneum outside the pelvis and/or metastasis to the retroperitoneal lymph nodes > 10 mm in greatest dimension 
J. Tumor involves 1 or both ovaries with microscopic extrapelvic peritoneal involvement with or without positive retroperitoneal lymph nodes
K. Tumor involves 1 or both ovaries with macroscopic peritoneal metastases beyond the pelvic brim <= 2 cm in greatest dimension, with or without metastasis to the retroperitoneal lymph nodes
L. Tumor involves 1 or both ovaries with macroscopic peritoneal metastases beyond the pelvic brim > 2 cm in greatest dimension, with or without metastases to the retroperitoneal nodes
M. Distant metastasis excluding peritoneal metastasis and pleural effusion with positive cytology
N. Distant metastasis excluding peritoneal metastasis and metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside of abdominal cavity)

# Conditions
- A
- B
- C
- D
- E
- F
- G
- H
- I
- J
- K
- L
- M
- N
- true

The calculator in question is the TNM Classification for Ovarian, Fallopian Tube, and Primary Peritoneal Carcinoma. TNM stands for Tumor, Node, Metastasis, and it is a globally recognized system used for the staging of various types of cancers. This specific TNM classification is applicable to patients diagnosed with ovarian, fallopian tube, or primary peritoneal carcinoma.

The clinical utility of this calculator is to provide a standardized way to describe the extent of disease progression in these patients. It helps in determining the stage of the cancer based on the size of the tumor (T), the involvement of lymph nodes (N), and the presence of distant metastasis (M). This information is crucial for clinicians to decide on the most appropriate treatment plan and to predict the patient's prognosis.

There are no specific exclusion criteria for the use of this calculator. However, it should be noted that the TNM classification is not applicable for borderline ovarian tumors and it does not replace the need for histopathological evaluation. It is also important to remember that the TNM staging system is just one aspect of the overall clinical assessment of a patient with cancer.

TNM classification for ovarian, fallopian tube, and primary peritoneal carcinoma

# Criteria
 ## Tumor classification
A. Tx: Primary tumor cannot be assessed
B. T0: No evidence of primary tumor
C. T1a: Tumor limited to one ovary (capsule intact) or fallopian tube surface; no malignant cells in ascites or peritoneal washings
D. T1b: Tumor limited to one or both ovaries (capsules intact) or fallopian tubes, no tumor on ovarian or fallopian tube surface; no malignant cells in ascites or peritoneal washings
E. T1c: Tumor limited to one or both ovaries with any of ruptured capsule, tumor on ovarian surface, malignant cells in ascites or peritoneal washings
F. T2a: Tumor involves one or both ovaries or fallopian tubes with pelvic extension or primary peritoneal cancer, extension and/or implants on uterus and/or fallopian tube and/or ovaries
G. T2b: Tumor involves one or both ovaries or fallopian tubes with pelvic extension or primary peritoneal cancer, extension to and/or implants on other pelvic tissues
H. T3a: Microscopic extrapelvic (above the pelvic brim) metastasis, peritoneal involvement with or without positive retroperitoneal lymph nodes
I. T3b: Macroscopic peritoneal metastasis beyond pelvis <= 2 cm in diameter with or without retroperitoneal lymph nodes
J. T3c: Macroscopic peritoneal metastasis beyond pelvis > 2 cm in diameter with or without metastasis to the retroperitoneal lymph nodes (including the extension of tumor to the capsule of liver and spleen without parenchymal involvement of either organ)
## Lymph node classification
K. Nx: Regional lymph nodes cannot be assessed
L. N0: No regional lymph node metastasis
M. N0(i+): isolated tumor cells in regional lymph nodes <= 0.2 mm
N. N1a: Metastasis <= 10 mm in greatest dimension
O. N1b: Metastasis > 10 mm in greatest dimension
## Distant metastasis
P. M0: No distant metastasis
Q. M1a: Pleural effusion with positive cytology
R. M1b: Liver or splenic parenchymal metastases, metastases to extra-abdominal organs (including inguinal lymph nodes and lymph nodes outside abdominal cavity), transmural involvement of intestine

# Conditions
- C and (L or M) and P
- D and (L or M) and P
- E and (L or M) and P
- F and (L or M) and P
- G and (L or M) and P
- (C or D or E or F or G) and (N or O) and P
- H and (L or M or N or O) and P
- I and (L or M or N or O) and P
- J and (L or M or N or O) and P
- (C or D or E or F or G or H or I or J) and (L or M or N or O) and Q
- (C or D or E or F or G or H or I or J) and (L or M or N or O) and R
- true

The Eastern Cooperative Oncology Group (ECOG) performance status, also known as the ECOG score, is a widely used tool in oncology to assess a patient's level of functioning in terms of their ability to care for themselves, daily activity, and physical ability (walking, working, etc.). It is applicable to patients with cancer of any type and at any stage.

The ECOG score ranges from 0 to 5, with 0 indicating fully active and able to carry on all pre-disease activities without restriction, and 5 indicating death. The score is used to determine a patient's prognosis, assess how a disease is progressing, and to determine appropriate treatment strategies. It is also often used in clinical trials to assess eligibility and to monitor patient progress.

There are no specific exclusion criteria for the use of the ECOG score, but it is important to note that it is a subjective measure and may not fully capture a patient's functional status. It is also less useful in patients with fluctuating or rapidly changing conditions.

Eastern Cooperative Oncology Group performance status (ECOG score)

# Criteria
 ## Patient description
A. Fully active, able to carry on all pre-disease performance without restriction
B. Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, such as light housework, office work
C. Ambulatory and capable of all self-care but unable to carry out any work activities; up and about more than 50% of waking hours
D. Capable of only limited self-care, confined to bed or chair more than 50% of waking hours
E. Completely disabled, cannot carry on any self-care, totally confined to bed or chair
F. Dead

# Conditions
- A
- B
- C
- D
- E
- F
- true

The Karnofsky Performance Status Scale (KPSS) is a clinical calculator used primarily in patients with cancer. It is a simple, numerical scale that measures a patient's functional status, ability to perform daily activities, and overall quality of life. The KPSS ranges from 0 (indicating death) to 100 (indicating perfect health). 

The clinical utility of the KPSS is to assess a patient's prognosis, determine appropriate treatment strategies, and monitor changes in a patient's condition over time. It is particularly useful in oncology for determining eligibility for certain treatments, such as chemotherapy or surgery, and for predicting survival outcomes. 

There are no specific exclusion criteria for the use of the KPSS. However, it is less useful in patients with non-cancer illnesses or in those with cognitive impairment who may not be able to accurately self-report their functional status.

Karnofsky Performance Scale

# Criteria
 ## Patient description
A. Normal, no complaints, no evidence of disease
B. Able to carry on normal activity, minor signs or symptoms of disease
C. Normal activity with effort, some signs or symptoms of disease
D. Cares for self, unable to carry on normal activity or to do active work
E. Requires occasional assistance but is able to care for most personal needs
F. Requires considerable assistance and frequent medical care
G. Disabled, requires special care and assistance
H. Severely disabled, hospital admission is indicated, death not imminent
I. Very sick, hospital admission necessary, active supportive treatment necessary
J. Moribund
K. Dead

# Conditions
- A
- B
- C
- D
- E
- F
- G
- H
- I
- J
- K
- true

The Modified Glasgow Prognostic Score (mGPS) is a clinical calculator used in the field of oncology to predict the prognosis of patients with cancer. It is applicable to a wide range of cancer types and stages, making it a versatile tool for clinicians. The mGPS is based on two simple, routinely measured inflammatory markers: C-reactive protein (CRP) and albumin levels. 

The clinical utility of the mGPS lies in its ability to stratify patients into different risk groups based on their inflammatory response to cancer. This can guide clinicians in making decisions about treatment strategies and follow-up plans. It can also provide valuable prognostic information to patients and their families.

There are no specific exclusion criteria for the use of the mGPS. However, it should be noted that the score may not be as accurate in patients with concurrent inflammatory or infectious conditions, as these can also affect CRP and albumin levels. Additionally, the mGPS may not be applicable to patients with rare types of cancer or those with very early or very advanced disease, as it has not been extensively validated in these groups.

Modified Glasgow Prognostic Score for cancer outcomes (mGPS)

# Criteria
 ## C-reactive protein
A. <= 10 mg/L
B. > 10 mg/L
## Albumin
C. < 3.5 g/dL [35 g/L]
D. >= 3.5 g/dL [35 g/L]

# Conditions
- A and (C or D)
- B and D
- B and C
- true

Non-epithelial ovarian cancer

Guidelines

Key sources