Incidence of lymph node metastasis in early-stage low-grade serous ovarian cancer: a systematic review

Abstract

ObjectiveThe objective of this systematic review was to assess the incidence of lymph node metastasis in patients with clinically presumed early-stage low-grade serous ovarian cancer that underwent primary surgical treatment.MethodsThis study was registered in PROSPERO (CRD42022308923). A systematic literature review was conducted following the Meta-analyses Of Observational Studies in Epidemiology (MOOSE) checklist. PubMed/MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Ovid, and Scopus databases were searched since inception and up to March 2022. The inclusion criteria were: pathological confirmation of low-grade serous ovarian cancer (clinically presumed FIGO 2014 stages I-IIA at time of surgery) that underwent primary surgical treatment, including pelvic and/or para-aortic lymph node dissection.ResultsThe search identified 3763 articles; 59 were considered potentially eligible after removing duplicates, and eight studies finally met the selection criteria. In total, 35 of 277 (12.6%) patients had lymph node metastasis, and only four studies reported upstaging due to lymph node metastasis in 16 of 153 (10.5%) patients. None of the eight studies included reported the rate of complications or complications specifically for the subgroup of patients with early-stage low-grade tumors.ConclusionIn patients with early-stage low-grade serous ovarian cancer, lymph node assessment should be discussed when counseling for primary surgical staging.

Role of ultrasound in detection of lymph‐node metastasis in gynecological cancer: systematic review and meta‐analysis

“…Involvement of pelvic lymph nodes in gynecological cancer is one of the most important factors for a poor prognosis [8][9][10][11] . Approximately 5-30% of women with early-stage gynecological cancer have pelvic lymph-node metastasis, and the probability of having such metastasis seems to be even higher in advanced stages [27][28][29][30] . However, the identification of pelvic lymph nodes is not an easy task.…”