Pelvic and aortic lymph node metastasis in epithelial ovarian cancer

Augusto Pereira, Javier F. Magrina, Victoria Rey, Manuel Cortes, Paul M. Magtibay

Research output: Contribution to journalArticle

58 Scopus citations

Abstract

Objective.: The appropriate management of advanced ovarian cancer has been controversial in recent years. There are no adequate data about the importance of lymphadenectomy and the appropriate sites for lymph node assessment. We sought to evaluate the distribution, size, and number of pelvic and aortic lymph node metastases in patients with epithelial ovarian carcinoma. Methods.: Retrospective chart review of 116 patients with stage IIIC or IV epithelial ovarian carcinoma treated at Mayo Clinic who underwent systematic bilateral pelvic and aortic lymphadenectomy between 1996 and 2000. Results.: Eighty-six (78%) of 110 patients who underwent pelvic lymphadenectomy were found to have nodal metastases in 422 (16%) of 2705 pelvic nodes that were removed. Eighty-four (84%) of 100 patients had documented aortic lymph node metastases in 456 (35%) of 1313 aortic nodes that were removed. Fifty-five (59%) of 94 patients had bilateral metastatic pelvic and aortic lymph nodes and bilateral aortic lymphadenectomy was conducted in 53 (72%) of 74 patients. The most representative group for detection of nodal metastases was the aortic group (83%) followed by the external iliac group (59%) and the obturator nodes (53%). There was no significant difference between the mean size of positive (1.8 cm) and negative nodes (1.6 cm). Thirty-seven patients had unilateral tumor, and 1 patient (7%) had contralateral node metastasis. Conclusion.: The incidence of positive nodes bilaterally and positive high aortic nodes indicates the need for bilateral pelvic and aortic node dissection (extending above the inferior mesenteric artery) in all patients regardless of laterality of the primary tumor.

Original languageEnglish (US)
Pages (from-to)604-608
Number of pages5
JournalGynecologic oncology
Volume105
Issue number3
DOIs
StatePublished - Jun 1 2007

    Fingerprint

Keywords

  • Aortic lymph node
  • Aortic lymphadenectomy
  • Epithelial ovarian cancer
  • Pelvic lymph node
  • Pelvic lymphadenectomy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this