Lymph node involvement and the role of lymphadenectomy in patients with advanced ovarian cancer

Stanislav Slavchev, Angel Yordanov, Vasil Nanev, Denislava Ivanova, Momchil Ivanov, Strahil Strashilov

Abstract

Background
Ovarian carcinoma (OC) is one of the most common types of cancer diagnosed in women and its clinical significance is reflected in the leading place it holds in the morbidity and mortality rates among women diagnosed with cancer. The evaluation of lymph node involvement by the oncosurgeons is a pivotal step towards proper disease staging and adjuvant therapeutic choices, towards optimal treatment outcomes.

Aims
The aim of this study was to investigate the lymph node metastases and patient characteristics in women with advanced OC (FIGO II-IV).

Methods
The study includes 58 patients with advanced OC (FIGO II-IV) operate in our clinic for the period 2004-2012. The patients were analysed with respect to age, FIGO stage, histological type and tumour grading, type of surgical verification of lymph nodes (biopsy, pelvic and/or para- aortic lymphadenectomy), results from histopathological reports describing the extent of lymphatic involvement, localization of lymph node metastases, and presence of ascites.

Results
Lymph node metastases were found in 56.7 per cent of the patients. 24.1 per cent of the patients had micrometastases in lymph nodes that were not initially detected on both pre- operative diagnostic imaging and intraoperative inspection.
 
Conclusion
The only reliable method for initial/early detection of lymphatic metastases in patients with OC is the surgical, through lymphadenectomy, with subsequent histological evaluation.
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