Pelvic and paraaortic lymphadenectomy in epithelial ovarian carcinomas. Report of 86 cases.

Aim of the study: The impact of lymphadenectomy in therapeutic strategy of ovarian carcinomas is strongly debated. The aim of this retrospective study was to report a series of 86 patients with ovarian carcinoma who underwent pelvic and paraaortic lymphadenectomy. Patients and method: From 1993 to 1998, a retroperitoneal lymphadenectomy was performed in 86 patients (median age : 54 years) during the first laparotomy (n = 52) or later (n = 34) for ovarian carcinoma stade I and II (n = 33), stade III and IV (n = 53). Sixty patients underwent pelvic and paraaortic lymphadenectomy with separate study of the different groups of nodes. Results: There was a lymph node involvement in 48.8 % of ail cases and in 36 % of stade I and II carcinomas. Lymph node involvement was observed for all histological types. It was present in both pelvic and paraaortic nodes in 52,3 % of the patients N+. Its incidence was 46.1 % in patients before chemotherapy and 52.9 % in patients after chemotherapy. It may concern all anatomical location with a 5 to 31 % frequency. There was no postoperative death and a low morbidity rate (13.9 %). Conclusions: Retroperitoneal lymphadenectomy is feasible; it is a contribution to the tumoral cytoreduction and to a better classification of ovarian carcinomas. According to this series and to the other reported series, an initial, complete, pelvic and paraaortic lymphadenectomy should be recommended for all cases of ovarian carcinomas but prospective randomised trials are necessary to appreciate the impact of this lymphadenectomy on survival. (C) 2000 Editions scientifiques et medicales Elsevier SAS.