PT - JOURNAL ARTICLE AU - Annalisa Garbi AU - Vanna Zanagnolo AU - Nicoletta Colombo AU - Giovanni Aletti AU - Maria Teresa Achilarre AU - Luca Bocciolone AU - Fabio Landoni AU - Stefania Rizzo AU - Roberto Biffi AU - Angelo Maggioni TI - Feasibility of Transabdominal Cardiophrenic Lymphnode Dissection in Advanced Ovarian Cancer: Initial Experience at a Tertiary Center AID - 10.1097/IGC.0000000000000983 DP - 2017 Jul 01 TA - International Journal of Gynecologic Cancer PG - 1268--1273 VI - 27 IP - 6 4099 - http://ijgc.bmj.com/content/27/6/1268.short 4100 - http://ijgc.bmj.com/content/27/6/1268.full SO - Int J Gynecol Cancer2017 Jul 01; 27 AB - Objectives The purpose of this retrospective report is to define the safety and feasibility, based on our preliminary experience, of surgical transdiaphragmatic resection of enlarged cardiophrenic lymph nodes (CPLNs), as a part of upfront debulking surgery. Supradiaphragmatic nodes located between the diaphragm and the heart are frequently a location for lymph node metastasis in advanced ovarian cancer, and their removal is aimed to obtain no gross residual disease at the primary cytoreductive surgery often requiring aggressive surgical procedures.Patients and Methods Between May 2012 and October 2016, a total of 22 patients among 443 with advanced high-grade serous ovarian cancer underwent cytoreductive procedures involving transdiaphragmatic resection of enlarged CPLNs at European Institute of Oncology in Milan.Results All patients who underwent CPLN resection had an extensive disease (median peritoneal cancer index, 18), and more than 77% required complex surgical procedures (complexity score, 3). No residual abdominal disease less than 5 mm at the end of surgery was described in 20 (90%) out of 22. All patients but one had confirmed CPLN positive nodes at histopathological study. The average operative time was 333 min (range, 244–455 min), and the average estimated blood loss was 1000 mL (range, 400–2000 mL). Blood transfusion was necessary in 13 out of 22 patients. Only 7 (33%) out of 21 patients required chest tube placement during the postoperative period.Conclusions Transdiaphragmatic enlarged CPLN resection seems to be safe and feasible procedure when indicated to achieve no or minimal tumor residual disease. Nevertheless, its impact on survival of patients with stage IV ovarian cancer needs to be determined.