abstract
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.
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