Introduction/Background*Recent findings have suggested that lymphadenectomy during primary cytoreductive surgery (CRS) in patients with ovarian cancer was not associated with an improve in survival, at the expense of a high morbidity. The aim of our study was to evaluate the impact of lymphadenectomy in patients with high-grade serous ovarian cancer benefitting from neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS).

Methodology A retrospective, unicentric study including all patients undergoing NACT and IDS was carried out from 2005-2018. Patients with and without lymphadenectomy were compared in terms of recurrence free survival (RFS), overall survival (OS), and complication rates. Survival was assessed using a Cox regression model and Kaplan Meyer curves.

Result(s)*We included 203 patients. Of these, 133 had a lymphadenectomy (65.5%) and 77 had involved nodes (57.9%). Patients who did not benefit from a lymphadenectomy were older with a more extensive disease and lesser rate of complete CRS. No differences were noted between the lymphadenectomy and no lymphadenectomy group concerning 2-year RFS (47.4% and 48.6%, p=0.87, respectively) and 5-year OS (63.2% versus 58.6%, p=0.41, respectively). Post-operative complications tended to be more frequent in the group with a lymphadenectomy (18.57 versus 31.58, p=0.09). In the group of patients with lymphadenectomy, survival was significantly altered in patients with involved nodes (positive lymph nodes: 2-year RFS 42.5% and 5-year OS 49.4%, negative nodes: 2-year RFS 60.7% and 5-year OS 82.2%, p= 0.03 and p<0.001 , respectively).

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Abstract 240 Figure 1

Patients with a stage IIB-IV high grade serous ovarian cancer who underwent neo-adjuvant chemotherapy followed by interval debulking surgery either with or without systematic lymphadenectomy (LND)A. Recurrence free survival (RFS) of patients with a stage IIB-IV ovarian cancer who underwent neo-adjuvant chemotherapy followed by interval debulking surgery (p=0.3)B. Overall survival (OS) of patients with a stage IIB-IV ovarian cancer who underwent neo-adjuvant chemotherapy followed by interval debulking surgery (p=0.6)

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Abstract 240 Figure 2

Patients with a stage IIB-IV high-grade serous ovarian cancer who underwent neoadjuvant chemotherapy followed by interval debulking surgery with a systematic lymphadenectomy. A) Recurrence free survival (RFS) according to node status after neo-adjuvant chemotherapy (p<0.001); B) Overall survival (OS) according to node status after neo-adjuvant chemotherapy (p<0.001)

Conclusion*Lymphadenectomy during IDS does not improve survival and increases post-operative complications.