Short-Term Morbidity in Transdiaphragmatic Cardiophrenic Lymph Node Resection for Advanced Stage Gynecologic Cancer

• Published in: Gynecologic oncology reports Vol. 17; no. C; pp. 33 - 37
• Main Authors: LaFargue, C.J, Sawyer, B.T, Bristow, R.E
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.08.2016; Elsevier
• Subjects: Cardiophrenic lymph nodes; Case Series; Cytoreductive surgery; Diaphragm resection; Hematology, Oncology and Palliative Medicine; Obstetrics and Gynecology; Ovarian cancer; Post-operative morbidity; post-operative morbidity; diaphragm resection; cardiophrenic lymph nodes; cytoreductive surgery; Ovarian cancer; Diaphragm resection; Post-operative morbidity; Cardiophrenic lymph nodes; Cytoreductive surgery
• ISSN: 2352-5789; 2352-5789
• DOI: 10.1016/j.gore.2016.05.006

Abstract Ovarian cancer is commonly diagnosed at an advanced stage, with disease involving the upper abdomen. The finding of enlarged cardiophrenic lymph nodes (CPLN) on pre-operative imaging often indicates the presence of malignant spread to the mediastinum. Surgical resection of CPLN through a transdiaphragmatic approach can help to achieve cytoreduction to no gross residual. A retrospective chart review was conducted on all patients who underwent transdiaphragmatic cardiophrenic lymph node resection from 8/1/11 through 2/1/15. All relevant pre-, intra-, and post-operative characteristics and findings were recorded. A brief description of the surgical technique is included for reference. Eleven patients were identified who had undergone transdiaphragmatic resection of cardiophrenic lymph nodes. Malignancy was identified in 18/21 (86%) of total lymph nodes submitted. The median number of post-operative days was 7. The overall post-operative morbidity associated with CPLN resection was low, with the most common finding being a small pleural effusion present on chest x-ray between POD# 3–5 (55%). Transdiaphragmatic CPLN resection is a feasible procedure with relatively minor short-term post-operative morbidities that can be used to achieve cytoreduction to no gross residual disease.