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Archives of Gynecology and Obstetrics

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01-05-2014 | Gynecologic Oncology

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

Authors: Volkan Ulker, Oguzhan Kuru, Ceyhun Numanoglu, Ozgur Akbayır, Ibrahim Polat, Mehmet Uhri

Published in: Archives of Gynecology and Obstetrics | Issue 5/2014

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.

Kwon YS, Hahn HS, Kim TJ, Lee IH, Lim KT, Lee KH et al (2009) Fertility preservation in patients with early epithelial ovarian cancer. J Gynecol Oncol 20(1):44–47PubMedCentralPubMedCrossRef

Powless CA, Aletti GD, Bakkum-Gamez JN, Cliby WA (2011) Risk factors for lymph node metastasis in apparent early-stage epithelial ovarian cancer: implications for surgical staging. Gynecol Oncol 122(3):536–540PubMedCrossRef

Benedet JL, Bender H, Jones H 3rd, Ngan HY, Pecorelli S (2000) FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology. Int J Gynaecol Obstet 70:209–262PubMedCrossRef

Maggioni A, Benedetti Panici P, Dell’Anna T, Landoni F, Lissoni A, Pellegrino A et al (2006) Randomised study of systematic lymphadenectomy in patients with epithelial ovarian cancer macroscopically confined to the pelvis. Br J Cancer 95(6):699–704PubMedCentralPubMedCrossRef

Chan JK, Urban R, Hu JM, Shin JY, Husain A, Teng NN et al (2007) The potential therapeutic role of lymph node resection in epithelial ovarian cancer: a study of 13918 patients. Br J Cancer 96(12):1817–1822PubMedCentralPubMedCrossRef

Desteli GA, Gultekin M, Usubutun A, Yuce K, Ayhan A (2010) Lymph node metastasis in grossly apparent clinical stage Ia epithelial ovarian cancer: hacettepe experience and review of literature. World J Surg Oncol 30(8):106CrossRef

Benedetti-Panici P, Greggi S, Maneschi F, Scambia G, Amoroso M, Rabitti C et al (1993) Anatomical and pathological study of retroperitoneal nodes in epithelial ovarian cancer. Gynecol Oncol 51(2):150–154PubMedCrossRef

Onda T, Yoshikava H, Yokota H, Yasugi T, Taketani Y (1996) Assessment of metastases to aortic and pelvic lymph nodes in epithelial ovarian carcinoma. A proposal for essential sites for lymph node biopsy. Cancer 78(4):803–808PubMedCrossRef

Chen SS, Lee L (1983) Incidence of para-aortic and pelvic lymph-node metastases in epithelial carcinoma of the ovary. Gynecol Oncol 16(1):95–100PubMedCrossRef

10.

Carnino F, Fuda G, Ciccone G, Iskra L, Guercio E, Dadone D et al (1997) Significance of lymph nodes sampling in epithelial carcinoma of the ovary. Gynecol Oncol 65(3):467–472PubMedCrossRef

11.

Petru E, Lahousen M, Tamussino K, Pickel H, Stranzl H, Stettner H et al (1994) Lymphadenectomy in stage I ovarian cancer. Am J Obstet Gynecol 170(2):656–662PubMedCrossRef

12.

Cass I, Runowicz CD, Fields AL, Goldberg GL, Leuchter RS, Lagasse LD, Karlan BY (2001) Pattern of lymph node metastases in clinically unilateral stage I invasive epithelial ovarian carcinomas. Gynecol Oncol 80(1):56–61PubMedCrossRef

13.

Chan JK, Munro EG, Cheung MK, Husain A, Teng NN, Berek JS, Osann K (2007) Association of lymphadenectomy and survival in stage I ovarian cancer patients. Obstet Gynecol 109(1):12–19PubMedCrossRef

14.

Ayhan A, Gultekin M, Taskiran C, Celik NY, Usubutun A, Kucukali T, Yuce K (2005) Lymphatic metastasis in epithelial ovarian carcinoma with espect to clinicopathological variables. Gynecol Oncol 97(2):400–404PubMedCrossRef

15.

Aletti GD, Dowdy S, Podratz KC, Cliby WA (2006) Role of lymphadenectomy in the management of grossly apparent advanced stage epithelial ovarian cancer. Am J Obstet Gynecol 195(6):1862–1868PubMedCrossRef

16.

Ditto A, Martinelli F, Reato C, Kusamura S, Solima E, Fontanelli R et al (2012) Systematic para-aortic and pelvic lymphadenectomy in early stage epithelial ovarian cancer: a prospective study. Ann Surg Oncol 19(12):3849–3855PubMedCrossRef

17.

Frumovitz M, Schmeler KM, Malpica A, Sood AK, Gershenson DM (2010) Unmasking the complexities of mucinous ovarian carcinoma. Gynecol Oncol 117(3):491–496PubMedCrossRef

18.

Ji J, Försti A, Sundquist J, Lenner P, Hemminki K (2008) Survival in ovarian cancer patients by histology and family history. Acta Oncol 47(6):1133–1139PubMedCrossRef

19.

Cho YH, Kim DY, Kim JH, Kim YM, Kim KR, Kim YT et al (2006) Is complete surgical staging necessary in patients with stage I mucinous epithelial ovarian tumors? Gynecol Oncol 103(3):878–882PubMedCrossRef

20.

Suzuki M, Ohwada M, Yamada T, Kohno T, Sekiguchi I, Sato I (2000) Lymph node metastasis in stage I epithelial ovarian cancer. Gynecol Oncol 79(2):305–308PubMedCrossRef

21.

Havrilesky LJ, Peterson BL, Dryden DK, Soper JT, Clarke-Pearson DL, Berchuck A (2003) Predictors of clinical outcomes in the laparoscopic management of adnexal masses. Obstet Gynecol 102(2):243PubMedCrossRef

22.

Canis M, Botchorishvili R, Manhes H, Wattiez A, Mage G, Pouly JL et al (2000) Management of adnexal masses: role and risk of laparoscopy. Semin Surg Oncol 19(1):28–35PubMedCrossRef

23.

Canis M, Rabischong B, Botchorishvili R, Tamburro S, Wattiez A, Mage G et al (2001) Risk of spread of ovarian cancer after laparoscopic surgery. Curr Opin Obstet Gynecol 13(1):9–14PubMedCrossRef

24.

Leminen A, Lehtovirta P (1999) Spread of ovarian cancer after laparoscopic surgery: report of eight cases. Gynecol Oncol 75(3):387–390PubMedCrossRef

25.

Sainz de la Cuesta R, Goff BA, Fuller AF Jr, Nikrui N, Eichhorn JH, Rice LW (1994) Prognostic importance of intraoperative rupture of malignant ovarian epithelial neoplasms. Obstet Gynecol 84(1):1–7PubMed

26.

Vergote I, De Brabanter J, Fyles A, Bertelsen K, Einhorn N, Sevelda P et al (2001) Prognostic importance of degree of differentiation and cyst rupture in stage I invasive epithelial ovarian carcinoma. Lancet 357(9251):176–182PubMedCrossRef

27.

Nezhat FR, Ezzati M, Chuang L, Shamshirsaz AA, Rahaman J, Gretz H (2009) Laparoscopic management of early ovarian and fallopian tube cancers: surgical and survival outcome. Am J Obstet Gynecol 200(1):83PubMed

28.

Park JY, Kim DY, Suh DS, Kim JH, Kim YM, Kim YT et al (2008) Comparison of laparoscopy and laparotomy in surgical staging of early-stage ovarian and fallopian tubal cancer. Ann Surg Oncol 15(7):2012–2019PubMedCrossRef

29.

Le T, Adolph A, Krepart GV, Lotocki R, Heywood MS (2002) The benefits of comprehensive surgical staging in the management of early-stage epithelial ovarian carcinoma. Gynecol Oncol 85(2):351–355PubMedCrossRef

Title: Lymph node metastasis in patients with epithelial ovarian cancer macroscopically confined to the ovary: review of a single-institution experience
Authors: Volkan Ulker
Oguzhan Kuru
Ceyhun Numanoglu
Ozgur Akbayır
Ibrahim Polat
Mehmet Uhri
Publication date: 01-05-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 5/2014
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-013-3078-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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