Should pelvic and para-aortic lymphadenectomy be different depending on histological subtype in epithelial ovarian cancer?

Ann Surg Oncol. 2008 Jan;15(1):333-8. doi: 10.1245/s10434-007-9639-6. Epub 2007 Oct 18.

Abstract

Background: The aim of this study was to determine the influence of the different histological subtypes (serous versus non-serous) on the location of nodal metastases in patients undergoing pelvic and para-aortic lymphadenectomies during the initial management of epithelial ovarian tumors.

Methods: We carried out a retrospective analysis of data concerning patients fulfilling the following inclusion criteria: (1) an epithelial ovarian tumor; (2) a complete pelvic and bilateral para-aortic lymphadenectomy up to the level of the left renal vein; (3) surgical procedures including lymphadenectomies performed before adjuvant chemotherapy; and (4) a description of the distribution of positive nodes removed between pelvic and para-aortic areas. Patients were classified into two groups according to the histological subtypes: serous (group 1) and non-serous (group 2) tumors.

Results: Of patients treated between 1989 and 2005, 148 fulfilled the inclusion criteria: 73 had a serous tumor and 75 a non-serous tumor. Positive nodes were observed in 70 (47%) patients-47 (64%) in group 1 and 23 (31%) in group 2 (P < 0.05). But the distribution of involved nodes between pelvic and para-aortic areas in patients with positive nodes was not statistically different between the two groups. In both groups, the most common site for positive nodes in the para-aortic area was the left para-aortic group: 74% in group 1 and 61% in group 2 (NS).

Conclusions: This series suggests that the histological subtype has no impact on the distribution of positive nodes in pelvic and para-aortic areas in patients with epithelial ovarian tumors.

MeSH terms

  • Adenocarcinoma, Clear Cell / secondary
  • Adenocarcinoma, Clear Cell / surgery
  • Adenocarcinoma, Mucinous / secondary
  • Adenocarcinoma, Mucinous / surgery
  • Adult
  • Aged
  • Aorta
  • Carcinoma, Endometrioid / secondary
  • Carcinoma, Endometrioid / surgery
  • Chemotherapy, Adjuvant
  • Cystadenocarcinoma, Serous / secondary*
  • Cystadenocarcinoma, Serous / surgery
  • Female
  • Humans
  • Lymph Node Excision*
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Staging
  • Ovarian Neoplasms / pathology*
  • Ovarian Neoplasms / surgery
  • Para-Aortic Bodies
  • Pelvis
  • Prognosis
  • Retrospective Studies