Introduction/Background*Digestive tract resection is a common procedure performed in bulky advanced-stage ovarian cancer (AOC) to achieve complete cytoreductive surgery (CRS). Very few data are available on the incidence and the prognostic impact of mesenteric lymph node (MLN) involvement.
The aim of this study is to determine the incidence of MLN involvement in patients undergoing a digestive tract resection at the time of CRS for AOC and to analyze its prognostic impact.
Methodology A retrospective study including patients who underwent CRS for AOC between 2006 and 2017. Patient’s clinico-pathological characteristics were collected, incidence of various LN basin involvement were analyzed focusing on MLN. Overall survival (OS) and disease free survival (DFS) were calculated with the KM method.
Result(s)*During the study period 72 of 176 (40.9%) patients with stage III-IVa AOC had a digestive tract resection during CRS with the recto-sigmoid resection being the most frequent (52 patients). There was an involvement of the serosa in 38 (52.8%), sub-serosa in 10 (13.9%), muscularis propria in 10 (13.9%), and mucosa in 5 cases (6.9%), respectively. MLN were found in 37 out of 72 (51.4%) patients with digestive tract resection. 25 patients (67.5%) had MLN involvement with a median of 5 involved nodes (range, 1 to 45). There was a trend in worse 5-year OS (45.8% vs 63.6%, p=0.064) for patients with MLN involvement.
Conclusion*Patients with AOC involving the digestive tract is associated with a high incidence of MLN metastasis. Resection of the associated lymphatic tributaries of affected bowel segment and correct pathological examination of the MLN should be performed regularly to improve staging and better evaluate their prognostic impact in case of LN involvement.
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