Clinical, Radiological, Pathological Correlation Of Nodal Status In Operable Epithelial Ovarian Cancer

Abstract

Background: The aim of this prospective study is to correlate radiological and intraoperative nodal characterization with pathological examination of pelvic and para-aortic nodes in operable epithelial ovarian cancer. Methods: The patients with epithelial ovarian cancer who had surgical cytoreduction were included in the study. These patients were subjected to radiological assessment of the abdomen with CT scan for nodal deposits in the para-aortic and pelvic region and it was followed by surgical cytoreduction. Intraoperatively, the nodes were palpated before, and after nodal basin, facial planes were dissected. After nodal dissection, the lymph nodes were grossed and sampled clinically as significant and insignificant and placed in separate jars. These nodes were pathologically assessed. Pathologically positive nodes were correlated with radiological, intraoperative and grossing findings. Results: Of the 27 patients, mean age was 45.6±10.9 years. Nine patients underwent upfront surgery, 18 patients underwent interval cytoreduction. A significant correlation was obtained (P Value <0.001) with grossing after surgery with the final histopathological report. The probable chance of identifying significant lymph nodes obtained in final pathological report from grossing after surgery in para-aortic nodes, right pelvic nodes, left pelvic nodes, right common iliac nodes and left common iliac nodes were 55%, 50%, 67.7%, 81.25% and 61.53% were positive for deposits and for insignificant lymph nodes obtained in final pathological report from grossing after surgery were 83.3%, 86.3%, 89.1%, 79% and 92% respectively were negative for deposits. Conclusion: Grossing after surgical dissection of the lymph nodes best correlates with final histopathology. CT scan findings for lymph nodal status in epithelial ovarian cancer does not correlate with final pathology.