Ovarian cancer: lymph node metastases

Purpose of investigation: To analyze pelvic and paraaortic lymph node involvement in epithelial ovarian cancer. Methods: Between 1995 and 2006, 60 patients with FIGO Stages II, III, IV epithelial ovarian cancer underwent Surgical treatment, including systematic pelvic and paraaortic lymphadenectomy. Results: Aortic lymph node metastases were documented in 45 (75%) patients and pelvic nodal metastases in 42 (70%). The incidence of paraaortic nodal involvement was 20% (12/60) in the absence of positive pelvic nodes while the incidence of pelvic nodal involvement was 15% (9/60) in the absence of paraaortic disease; both pelvic and paraaortic lymph node involvement occurred in 55% of patients. The most frequent groups for nodal metastases are paracaval (56%), externaliliac (60%), and obturator (55%). Conclusion: The rate of nodal involvement is important in ovarian cancer and there is a high prevalence of both pelvic and paraaortic lymph node metastases. For this reason bilateral pelvic and paraaortic lymphadenectomy is necessary for staging and as treatment for micrometastases, also in patients with unilateral tumors.