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