Lymph node metastasis in patients with epithelial ovarian cancer macroscopically confined to the ovary: review of a single-institution experience

• Published in: Archives of gynecology and obstetrics Vol. 289; no. 5; pp. 1087 - 1092
• Main Authors: Ulker, Volkan, Kuru, Oguzhan, Numanoglu, Ceyhun, Akbayır, Ozgur, Polat, Ibrahim, Uhri, Mehmet
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2014; Springer Nature B.V
• Subjects: Adenocarcinoma - secondary; Adenocarcinoma - surgery; Adult; Aged; Carcinoma, Ovarian Epithelial; Endocrinology; Female; Gynecologic Oncology; Gynecology; Histology; Human Genetics; Humans; Lymph Node Excision; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis - pathology; Lymphatic system; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Neoplasm Staging; Neoplasms, Glandular and Epithelial - pathology; Neoplasms, Glandular and Epithelial - surgery; Obstetrics/Perinatology/Midwifery; Ovarian cancer; Ovarian Neoplasms - pathology; Retrospective Studies; Risk Factors; Lymphadenectomy; Early stage; Epithelial ovarian cancer; Staging
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-013-3078-3

Background To evaluate the patterns of lymphatic spread in epithelial ovarian cancer (EOC) macroscopically confined to the ovary and to determine risk factors for lymph node metastasis. Materials and methods All patients with clinically apparent stage IA/B/C EOCs who underwent staging surgery between January 2003 and February 2013 were retrospectively identified. Results Two hundred and thirty-six ( n = 236) consecutive patients were operated for primary epithelial ovarian carcinoma. Sixty-two of these patients (26.2 %) who underwent a comprehensive staging procedure including pelvic and paraaortic lymphadenectomy were diagnosed with tumors confined to one or two ovaries (stage IA/B/C). Of these 62 patients, 17 (27.4 %) had upstaged disease and 8 (12.9 %) had lymph node metastasis. Tumor histology was serous in 25 patients (40.3 %), mucinous in 23 patients (37 %), endometrioid in 9 patients (14.5 %), and clear cell in 5 patients (8 %). Positive lymph node status was found in 20 % (5/25) of those with serous histology while this rate was only 8.1 % (3/37) in those with non-serous disease. Although the presence of ascites was not associated with an increased risk of lymph node involvement ( p = 0.24), positive peritoneal cytology ( p = 0.001) and grade 3 disease ( p = 0.001) were significant predictors of lymph node involvement. Conclusion All patients diagnosed with EOC macroscopically confined to the ovary should be considered for comprehensive staging surgery including pelvic and paraaortic lymphadenectomy.