Laparoscopic findings indicating that optimal cytoreduction is unlikely include Omental cake Extensive peritoneal or diaphragmatic carcinomatosis Mesenteric retraction Bowel and stomach infiltration Spleen and / or liver superficial metastasis Systemic or intraperitoneal chemotherapy In most patients with newly diagnosed ovarian cancer, the disease has spread widely throughout the peritoneum; thus, treatment involves one of the following (see table Postoperative Treatment of Ovarian Cancer by Stage and Type): Staging and cytoreduction, followed by 6 cycles of IV chemotherapy 3 cycles of neoadjuvant chemotherapy, followed by surgery and 3 more chemotherapy cycles Standard chemotherapy is 6 courses of paclitaxel and carboplatin.