Lymph node metastasis in patients with epithelial ovarian cancer macroscopically confined to the ovary: review of a single-institution experience

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Ulker V., Kuru O., Numanoglu C., Akbayir O., Polat I., Uhri M.

ARCHIVES OF GYNECOLOGY AND OBSTETRICS, cilt.289, sa.5, ss.1087-1092, 2014 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 289 Sayı: 5
  • Basım Tarihi: 2014
  • Doi Numarası: 10.1007/s00404-013-3078-3
  • Dergi Adı: ARCHIVES OF GYNECOLOGY AND OBSTETRICS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.1087-1092
  • Anahtar Kelimeler: Lymphadenectomy, Early stage, Epithelial ovarian cancer, Staging, PROGNOSTIC IMPORTANCE, LAPAROSCOPIC SURGERY, ADNEXAL MASSES, CARCINOMA, MANAGEMENT, LYMPHADENECTOMY, RISK, SURVIVAL, RUPTURE, SPREAD
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

Background: To evaluate the patterns of lymphatic spread in epithelial ovarian cancer (EOC) macroscopically confined to the ovary and to determine risk factors for lymph node metastasis.

Materials and methods: All patients with clinically apparent stage IA/B/C EOCs who underwent staging surgery between January 2003 and February 2013 were retrospectively identified.

Results: Two hundred and thirty-six (n = 236) consecutive patients were operated for primary epithelial ovarian carcinoma. Sixty-two of these patients (26.2 %) who underwent a comprehensive staging procedure including pelvic and paraaortic lymphadenectomy were diagnosed with tumors confined to one or two ovaries (stage IA/B/C). Of these 62 patients, 17 (27.4 %) had upstaged disease and 8 (12.9 %) had lymph node metastasis. Tumor histology was serous in 25 patients (40.3 %), mucinous in 23 patients (37 %), endometrioid in 9 patients (14.5 %), and clear cell in 5 patients (8 %). Positive lymph node status was found in 20 % (5/25) of those with serous histology while this rate was only 8.1 % (3/37) in those with non-serous disease. Although the presence of ascites was not associated with an increased risk of lymph node involvement (p = 0.24), positive peritoneal cytology (p = 0.001) and grade 3 disease (p = 0.001) were significant predictors of lymph node involvement.

Conclusion: All patients diagnosed with EOC macroscopically confined to the ovary should be considered for comprehensive staging surgery including pelvic and paraaortic lymphadenectomy.