Table 5 Summary table of local, nodal and haematogenous spread in ovarian carcinoma

Local spread

•Uterus and broad ligament (via the fallopian tube);

•Direct invasion of the rectum, colon, bladder and pelvic side wall

Lymph node spread

•Via lymphatics travelling along with the ovarian vessels to terminate in common iliac and para-aortic nodes;

•Via the broad ligament to terminate in the internal iliac and obturator nodes;

•Via the round ligament to terminate in the external iliac and inguinal nodes

Trans-coelomic spread

•Common sites: undersurface of the diaphragm, liver surface, pouch of Douglas, omentum, serosal bowel surfaces

Haematogenous spread

•This occurs late during the disease;

•Liver > lungs, kidney, bone

Note

•Ascites arise from increased production from tumour surfaces and/or occlusion of retroperitoneal lymph nodes