Introduction/Background Recent french recommandations narrowed indications of lymph node dissection in advanced epithetial ovarian cancer to clinically or radiologically significative adenopathy. The objective was to evaluate the predictive ability of imaging.
Methodology A prospective tricentric study was conducted in the gynaecologic oncologic departments of Lariboisiere, Creteil and Poissy Saint Germain Hospitals. Between 01st January 2004 and 31 July 2018, we included all women diagnosed with an advanced epithelial ovarian cancer who benefited lymph node resection. Clinical, radiological features of CT and PET scan and pathological reports were reported in our database. Sensitivity (Se), specificity (Spe), positive and negative predictive values (PPV and NPV) and likelihood ratios (pLR and nLR) of each imaging were calculated. We carried out an univariate analysis to find predictors of lymph node invasion based on imaging.
Results Final population included 84 patients. Mean age was 60 years old. There were 71 serous (85%), 4 endometrioids (5%), 2 mucinous (2%), 1 clear cell (1%), 5 undifferentiated (5%), 1 mixt (1%) adenocarcinomas. 40 patients had positive lymph nodes on the pathological report. 71 patients had a CT, with a sensitivity of 63%, specificity of 92%, pLR of 4,78, PPV of 84%, NPV of 77%. 14 patients had a PET with a sensitivity of 92%, specificity of 99% pLR of 15, PPV of 99%, NPV of 88%. In univariate analysis for predicting factors of positive lymph node, we did not find any association with the main usually described involvement as ascite, peritoneal carcinosis or metastases.
Conclusion PET scan is more performing than CT scan to diagnose lymph node invasion. CT and PET scan are probably two relevant imaging exams in the prediction of lymph nodes involvement but further research needs to be conducted.
Disclosure Nothing to disclose.
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