Introduction/Background The presence of suspicious cardiophrenic nodes (CPLN) on computed tomography (CT) upstages epithelial ovarian cancer (EOC) to stage IVB and its surgical resection has not been widely studied. In this study, we aimed to surgically evaluate CPLN in patients undergoing cytoreductive surgery (CRS) for advanced EOC who had suspicious CPLN on primary CT. The primary objective is to determine histopathological node positivity in radiologically suspicious CPLN. We also aim to determine the node yield, feasibility and safety of the procedure

Methodology It was a single centre prospective study, including all EOC patients undergoing CRS with CPLN debulking (CPLND) over 2 years for suspicious CPLN (≥ 5 mm) on primary CT. Complete gross resection (CGR) of abdominal disease was ensured before CPLND. All perioperative findings and histopathology reports were carefully recorded and analysed.

Results 30 cases underwent CPLND, out of which 93.3% (28/30) had at least ≥1 node yield. Median nodes dissected was 2 (0–16). 68.8% (11/16) patients undergoing Primary CRS and 64.3% (9/14) patients undergoing Interval CRS had node positive disease (64.3%). Opening up of pleura was seen in 23.3%. 33.3% (10/30) developed respiratory complications requiring BIPAP (1 was reintubated, 2 had post operative ICD insertion, 2 developed pneumonia and 1 required pleural fluid tapping. All had diaphragmatic stripping (10/10) and 7/10 needed diaphragmatic resection. Patients were discharged between POD5 and POD12 (median 7.5). Clavien Dindo score ≥III was seen in only 10% cases.

Conclusion Transdiaphragmatic CPLND is a feasible procedure. It should be included as part of CRS when enlarged or suspicious radiologically to achieve CGR. This is a pilot study and correlation data will be more concrete with further survival analysis and larger prospective studies.

Disclosures nil