Role of Lymphadenectomy in Treatment for Epithelial Ovarian Cancer

Abstract

To study the role of retroperitoneal lymphadenectomy in epithelial ovarian cancer (OC) the work was divided into two parts. In the first part for a retrospective analysis 852 patients with stage I-IV OC, who were treated from January 2000 to January 2014, were selected to investigate the localization of the first relapse of the disease. In the second part, prospective from August 2016 to April 2017, in 28 patients with stage I-IV OC the surgical stage of the combined treatment was supplemented by iliac-pelvic and para-aortic lymphadenectomy; in this group the results of surgical staging were studied. The incidence of isolated recurrence in para-aortic lymph nodes in the group of early OC was 3/28 (11%), in pelvic 2/28 (7%), whereas in the group of advanced OC - in para-aortic lymph nodes 9/24 (37%), in iliac-pelvic 10/24 (42%), combined in pelvic and para-aortic lymph nodes 5/24 (21%). In the prospective group the lesion of pelvic and para-aortic lymph nodes was observed in 2/28 (7%) of patients with the presumed I stage of the disease and in 2/28 (7%) with the presumed stage II, which resulted in re-staging of the disease. In 2 cases the clinical IA and IB stages were re-staged to IIIA and this required 6 courses of chemotherapy. In 2/28 (7%) patients metastases to para-aortic lymph nodes were detected in the absence of pelvic lesions.