Ovarian carcinoma with bowel infiltration spread like colon carcinoma – consequences for surgical treatment

• Published in: Geburtshilfe und Frauenheilkunde Vol. 66; no. S 01
• Main Authors: Unversucht, A, Hentschel, B, Hentsch, S, Einenkel, J, Horn, LC
• Format: Conference Proceeding Journal Article
• Language: English; German
• Published: 19.09.2006
• ISSN: 0016-5751; 1438-8804
• DOI: 10.1055/s-2006-952552

Aims: About 20–25% of patients with advanced ovarian cancer (OCX; FIGO-stage IIB-IV) need bowel resection for optimal tumor debulking (DuBois et al 2005). But, additional intestinal surgery in these patients might be affected by surgical complications and post-operative morbidity. The study examines the occurrence of mesenteric lymph node metastases in correlation to the depth of infiltration of OCX into the bowels wall and the detection of lymphovascular space involvement (LVSI). Methods: The histologic slides of 29 cases of OCX with additional bowel resection were re-examined regarding the infiltration of the OCX into the mesenteric fatty tissue, the lamina msucularis or up to the lamina mucosa. At the bowel infiltration site the slide were searched for cases without (L0) and with (L1) LVSI. Both parameters were correlated to the occurrence of mesenteric lymph node metastases. Results: 72.4% of all cases represented mesenteric lymph node involvement. The occurrence of lymph node metastases was correlated to the depth of invasion of the OCX into the bowels wall (p=0.04), but 50% of the cases with only superficial invasion into the pericolic fatty tissue represented metastases too. The detection of LVSI was also correlated with increased lymph node involvement (p=0.05). Conclusions: OCX with bowel infiltration spread into mesenteric nodes like colonic carcinoma. The frequency of mesenteric lymph node metastases is correlated to the depth of invasion into the bowels wall and the occurrence of LVSI at that location. But, also superficial bowels infiltration is associated with a high frequency of lymph nodes metastases, so bowels resection should be performed in all patients when infiltration is suspected intraoperatively.