Introduction/Background Epithelial ovarian cancer (EOC) is the most lethal of all gynecological malignancies. About 70% patients recur within 2 years of achieving complete clinical response after primary surgery and adjuvant chemotherapy.

Isolated lymph node recurrence (ILNR) is an uncommon finding occurring in about 1—6% patients. There has been no standard of care for ILNR in the literature. The aim of our study was to assess the clinical outcome of isolated lymph node recurrence in patients with EOC treated by surgery.

Methodology We conducted a retrospective analysis of all the EOC patients who underwent secondary surgery for ILNR 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-Meier for categorical variables and cox-proportional hazard progression for continuous variables.

Results A total of 21 patients of ILNR 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 resection 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. A single site of lymph node recurrence was associated with significantly better post-recurrence survival.

Conclusion Complete resection is feasible for EOC patients presenting with isolated lymph node recurrence, without any significant peri-operative morbidity. Young age, para-aortic lymph node dissection during primary surgery and single site of lymph node recurrence are associated with better prognosis.

Disclosures NIL.