Introduction/Background The aim of our study was to assess the clinical outcome of isolated lymph node recurrence in patients with epithelial ovarian cancer treated by surgery and to analyse the impact of various clinico-pathological factors on prognosis.

Methodology We conducted a retrospective analysis of all the epithelial ovarian cancer patients who underwent surgery for isolated lymph node recurrence at our institute from 2013 to 2020.Univariate analysis of various factors influencing the Post recurrence disease free survival and Post recurrence survival was done using Kaplan-Meir for categorical variables and cox-proportional hazard progression for continuous variables.

Results A total of 21 patients of isolated lymph node recurrence were treated surgically during the study period. The median Disease free interval to develop lymph nodal recurrence was 13 months. All the patients achieved complete cytoreduction to no gross residual disease without any significant morbidity associated with the procedure.The median Post recurrence disease free survival after treatment of lymph node recurrence was 25 months with 3-year Post recurrence survival of 72% and 3-year Overall survival of 85%.Amongst the factors influencing Post recurrence disease free survival, young age (< 50 years), para-aortic lymph node dissection at initial surgery and single site of lymph node recurrence were significantly associated with better prognosis.For the Post recurrence survival, single site of lymph node recurrence was associated with significantly better survival.

Conclusion Complete cytoreductive surgery is feasible for epithelial ovarian cancer patients presenting with isolated lymph node recurrence without any significant peri-operative morbidity and when combined with post-operative adjuvant chemotherapy is associated with favourable survival outcomes. Young age, para-aortic lymph node dissection during primary surgery and single site of lymph node recurrence are associated with significantly improved prognosis.