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325 Lymph node involvement in advanced ovarian cancer: patterns and risk factors
  1. Ines Zemni1,
  2. Selma Kacem2,
  3. Houyem Mansouri3,
  4. Yasmine Fertani1,
  5. Ines Zidi2,
  6. Nedia Boujelbene4 and
  7. Tarak 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 Lymph node dissection is still indicated in advanced ovarian cancer (AOC), when a complete cytoreductive surgery with no residual disease has been achieved and when the involvement of retroperitoneal lymph nodes has been assessed.

The aim of this study is to determine the patterns of lymph node involvement in AOC and the factors influencing this involvement.

Methodology We retrospectively reviewed all patients surgically managed for advanced stage ovarian cancer (FIGO IIB - IV) who underwent a lymph node dissection in the oncologic surgery department of the Salah Azaiez Institute, from January 2000 to December 2017.

Results In our study, 101 patients with AOC underwent a retroperitoneal lymphadenectomy.Lymph nodes were positive in 55.4% of patients. In these patients, the mean number of positive lymph nodes was 6.5 ± 7.15 with extremes ranging from 1 to 31. The mean node ratio was 0.13 (0–1).

Pelvic lymph nodes were positive in 40.8% of patients. Lombo-aortic lymph nodes were positive in 44%.Isolated lombo-aortic involvement was identified in 7.1%.

In univariate analysis, predictive factors of lymph node involvement were suspicious macroscopic appearance of lymph nodes intraoperatively, scanographic lymph node involvement, and serous type as predictive factors of lymph node positivity.

Conclusion AOC is associated with a high lymph node involvement rate. The identified predictive factors of involvement are the macroscopic and scanographic enlargement, besides the serous type.

Disclosures None.

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