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Ovarian Cancer
Lymph Node Involvement in Epithelial Ovarian Cancer: Sites and Risk Factors in a Series of 355 Patients
  1. Marion Fournier, MD*,
  2. Eberhard Stoeckle, MD*,
  3. Frédéric Guyon, MD*,
  4. Véronique Brouste, MD†,
  5. Laurence Thomas, MD‡,
  6. Gaëtan Macgrogan, MD§ and
  7. Anne Floquet, MD∥
  1. *Departments of Surgery,
  2. †Departments of Biostatistics,
  3. ‡Departments of Radiotherapy,
  4. §Departments of Pathology, and
  5. ∥Departments of Oncology, Comprehensive Regional Cancer Center, Institut BergoniéDepartments of , Bordeaux, France.
  1. Address correspondence and reprint requests to Eberhard Stoeckle, MD, Department of Surgery, Institut Bergonié, Regional Cancer Centre, 229,Cours de l'Argonne, 33076 Bordeaux Cedex, France. E-mail: stoeckle{at}bergonie.org.

Abstract

Objectives: To perform a cartography of lymph node metastases in epithelial ovarian cancer and to determine predictive factors of lymph node metastases.

Method: The charts of 355 patients with epithelial ovarian cancer who underwent lymphadenectomy during a primary (n = 252) or secondary debulking surgery (n = 103) were analyzed. The topography of the lymph node metastases was notified for the whole group according to the stage of the disease, the histological type, and the moment of surgery. In patients who underwent a primary surgery before chemotherapy, independent prognostic variables for the risk of lymph node involvement were tested with a multivariate analysis. Independent prognostic factors were combined to determine risk profiles in individual patients.

Results: The main area of the lymph node metastases was para-aortic. Isolated pelvic lymph node involvement was 10%. Three variables independently predicted lymph node invasion: advanced T stage, high-risk histological profile, and metastases.

Conclusions: When lymphadenectomy is recommended, systematic lymph node dissections in the aortic and pelvic areas are warranted. An isolated pelvic lymph node assessment, particularly in the early stages, is inappropriate. By combining independent risk factors, a useful tool for individual risk assessment of lymph node involvement could be established, helping to decide whether to perform a lymph node dissection, especially at restaging surgery.

  • Ovarian cancer
  • Lymph node metastases
  • Lymphadenectomy
  • Lymph node mapping
  • Risk factors
  • Surgery

https://doi.org/10.1111/IGC.0b013e3181b8a07c

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    Footnotes

    • This paper has not been supported by any funding.

    • The authors declare no conflict of interest.