DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20196043

Role of pelvic and para-aortic lymphadenectomy in epithelial ovarian cancers

Pankush Gupta, Sunesh Kumar, Seema Singhal, Jyoti Meena, Sandeep Mathur, Lalit Kumar

Abstract


Background: Lymphadenectomy in epithelial ovarian cancers has remained a controversial subject. Lack of robust evidence on survival benefits and surgical morbidity associated questions its role in the era of adjuvant chemotherapy. The present study assessed pelvic and para-aortic lymph node removal in epithelial ovarian cancer in Indian women and tried to find clinicopathological correlation of nodal involvement and postoperative implications of lymphadenectomy.

Methods: Thirty patients with diagnosis of epithelial ovarian cancer posted for primary debulking surgery were recruited and underwent staging laparotomy along with pelvic and para-aortic lymphadenectomy. Nodal involvement was confirmed on histopathology and various parameters which could predict nodal metastasis were assessed. Patients were followed up for 12 months post-surgery.

Results: Nodal yield was ten for pelvic and four for paraaortic nodes. Pelvic node involvement was seen in 26.6% (8/30) of the patients and para-aortic in 15% (3/20) of the patients. Serous histology, higher grade, stage 3 and above, positive peritoneal cytology, omental involvement showed a higher lymph node involvement though not statistically significant. Para-aortic lymphadenectomy was associated with increased operating time, blood loss and longer hospital stay.

Conclusions: Lymphadenectomy increases morbidity and decision should be based on predictors of nodal involvement.


Keywords


Epithelial ovarian cancer, Lymphadenectomy, Para-aortic, Pelvic

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References


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