Objectives To evaluate the role of lymphadenectomy in advanced epithelial ovarian cancer (EOC).

Methods Data of 121 patients who underwent surgery for FIGO staged IIB-IV EOC between 2000 and 2010 were retrospectively reviewed.

Results Primary debulking surgery was performed in 96 patients and interval debulking surgery in 25 cases. Maximal cytoreduction (R0) was achieved in 37 of patients (30.6%), 39 patients had a residual disease ≤1 cm (32.2%) and 45 had a residual disease <1 cm (37.2%). Lymphadenectomy was performed in 60 patients (50.4%). The 5 years OS and RFS were significantly correlated to the tumor stage, maximal cytoreduction, LN status (table1) and lymphadenectomy was an independent prognostic factor of OS (HR=1.696, 95% CI=1.025–2.807, p=0.04) and RFS (HR=2.162, 95% CI=1.334–3.504, p=0.002) with a higher survival rates in case of associated pelvic lymphadenectomy (PL) and para aortic lymphadenectomy (PAL). The 5 years RFS of patients with a residual disease of more than 1 cm was not significantly improved by lymphadenectomy (7.1% vs 24.2%, p=0.196) despite the gain in term of OS (7.2% vs 42.7%, p=0.006).

Conclusions Lymphadenectomy is associated with a better survival in patients with advanced ovarian cancer.