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324 Advanced ovarian cancer: impact of lymphadenectomy on morbi-mortality
  1. Selma Kacem1,
  2. Ines Zemni2,
  3. Houyem Mansouri3,
  4. Mehdi Mbarek1,
  5. Ines Zidi2,
  6. Nedia Boujelbene4 and
  7. Tarek Ben Dhieb5
  1. 1Department of Surgical Oncology, Tunis, Tunisia
  2. 2Salah Azaïz Institute, Tunis, Tunisia
  3. 3Faculty of Medicine, Jendouba, Tunisia
  4. 4Faculty of Medicine, Tunis, Tunisia
  5. 5Regional Hospital of Jendouba, Tunis, Tunisia


Introduction/Background Epithelial ovarian cancer (EOC) is the leading cause of death from gynecologic malignancy and is usually diagnosed in advanced stages.

Besides systemic treatments (chemotherapy and targeted therapy), cytoreductive surgery with an aim of no residual disease, remains the cornerstone of the management of EOC in advanced stages. In these stages, the purpose of lymphadenectomy is to remove the possibly involved retroperitoneal lymph nodes, always in order to achieve a maximal cytoreductive surgery. However, the role of lymphadenectomy has been largely debated due to its alleged high surgically related morbidities.

In this study we aimed to evalue the impact of lymphadenectomy on the post-operative morbi-mortality rates.

Methodology We retrospectively conducted a comparative study including all patients surgically managed for advanced stage EOC (FIGO IIB - IV) in the oncologic surgery department of the Salah Azaiez Institute, from January 2000 to December 2017.

We subdivided our patients in to two groups according to whether or not they have had a lymph node procedure (pelvic and/or lombo-aortic lymph node dissection).

Results Our study included 182 patients, 101 of whom had undergone lymphadenectomy (LN) and 81 of whom had not (NoLn). The two groups were similar in terms of age, history, WHO status, FIGO stage and first chemotherapy. The comparative study of peri-operative morbidity and mortality showed no statistically significant difference between the two groups. In fact, in the NoLn group, there were not statistically fewer intra-operative transfusions (p=0.54), shorter operating times (p=0.79) and fewer post operative deaths (p=0.54). Similarly, the length of hospital stay was not statistically significantly shorter in the NoLn group (p=0.73). The only post-operative complication that was more frequent in our series, in the LN group, was lymphoedema of the lower limbs (p=0.001).

Conclusion Lymphadenectomy had no negative effect on surgical morbidity in patients with EOC in advanced stages except for lymphoedema.

Disclosures None.

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