The first place where "upper" gynecologic cancers (uterine, ovarian, and tubal) spread is to the pelvic and abdominal areas.  This includes the lymph nodes in the vicinity, the outsides of abdominal organs such as the intestines, the omentum (an apron of fatty tissue in front of the intestines), and the underside of the diaphragm.  Cancer cells can also be floating through the fluid in the area.  During surgical staging, a surgeon (ideally a gynecologic oncologist) inspects these areas, takes biopsies, and "washes" the peritoneum with a salt solution which is then sent to the lab for inspection with a microscope.  Surgical staging is vital in order to plan the most effective treatment for all ovarian, uterine, and tubal cancers. 

Surgical staging can also include the removal of lymph nodes for examination and analysis in vulvar and other cancers.

More about gyn cancer staging, including links to the stages of individual cancers