Table 1.

Recommendations concerning neglected anatomical areas of ovarian cancer. PCI—peritoneal cancer index; PH—porta hepatis; HDL—hepatoduodenal ligament.

Anatomical Area	Evaluation—Recommended	Evaluation—Not Supported by Available Evidence
Omental bursa—transcoelomic dissemination [5,7,13,30,32,33,35]	PCI ≥ 17, peritoneal carcinomatosis in the upper abdomen, ascites, Morison’s pouch and diaphragmatic peritoneum dissemination	Adhesion in Winslow’s foramen
Omental bursa—lymph node dissemination (celiac, portal, triad) [5,7,13,30,32,33,35]	Enlarged paraaortic, mesenteric and suprarenal lymph nodes	Normal paraaortic, mesenteric and suprarenal lymph nodes
	Suspicious metastatic mediastinal lymph nodes as judged using imaging techniques
Morison’s pouch [51,52,53,54,55]	High PCI, ascites, peritoneal carcinomatosis, diaphragmatic dissemination, transcoelomic dissemination to the HDL	Isolated lymph node dissemination in the upper abdomen
Base of the round ligament of the liver [56,58,60]	PCI ≥ 10, ascites, peritoneal carcinomatosis at Glisson capsule and PH	Absence of peritoneal carcinomatosis at Glisson capsule and PH
The hepatic bridge [56,58,60]	Transcoelomic involvement of the round ligament, PCI ≥ 10	Absence of peritoneal carcinomatosis at Glisson capsule and PH
Hilum of the spleen [5,66,67,68,69,70]	Omental cake (greater omentum), transcoelomic OB involvement	Isolated lymph node dissemination in the upper abdomen
Suprarenal lymph nodes [72,74,75]	Enlarged infrarenal paraaortic lymph nodes	Normal infrarenal lymph nodes
Retrocrural lymph nodes [77,78]	Enlarged paraaortic, suprarenal, celiac and cardiophrenic lymph nodes	Normal paraaortic, suprarenal, celiac and cardiophrenic lymph nodes
Cardiophrenic lymph nodes [87,89,90,96]	Transcoelomic and lymphatic dissemination in the right upper abdomen, ascites, extra-abdominal disease	Not applicable
Inguinal lymph nodes [101,103,109,110]	Every patient. Particular attention should be paid for patients with inguinal hernia	Not applicable