Lymphocele and Ovarian Cancer: Risk Factors and Impact on Survival

Abstract

After completing this course, the reader will be able to:1. Identify risk factors for lymphoceles after cytoreductive surgery in ovarian cancer.2. Describe the impact of lymphocleles on outcomes in women with ovarian cancer. This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACT Introduction. We describe the incidence, impact on survival, and the risk factors for symptomatic lymphoceles in patients with ovarian cancer.Methods. This retrospective study includes patients with ovarian cancer who had complete cytoreductive surgery and para-aortic and pelvic lymphadenectomy performed in our institute from 2005 to 2011. Patients were classified into two groups: patients with symptomatic lymphoceles and a control group.Results. During the study period, 194 patients with epithelial ovarian cancer underwent cytoreductive surgery and a lymphadenectomy without macroscopic residual disease. Fifty-four patients had symptomatic lymphoceles (28%). In the multivariate analysis, only supraradical surgery was significantly and independently associated with

Use of TachoSil® to Prevent Symptomatic Lymphocele after an Aggressive Tumor Debulking with Lymphadenectomy for Advanced Stage Ovarian Cancer. A Pilot Study

“…As a consequence, lymphatic fluid tends to be accumulated in a uni or multilocular sacs call lymphocele, which occur within 4-8 weeks after surgery [11]. A total of 40% of patients without TachoSil® had SLC in our study; which is in agreement with other research in a similar setting of patients with comparable extensive surgical procedures [7]. It is interesting to note that the incidence of SLC can decrease up to 5.7% if all types of gynecological cancers with less radical procedures are included [12].…”

“…Of those complications, symptomatic lymphocele (SLC) is an important problem in over 35% of patients [6,7]. In addition to fever, abdominal pain, and tenesmus, symptomatic lymphocysts can cause hospital re-admission, surgical re-intervention and they can even potentially postpone adjuvant chemotherapy [8].…”

Modified posterior pelvic exenteration for advanced ovarian malignancies: a single-institution study of 35 cases

“…The most common late complication was symptomatic lymphocele, which accounted for over 66% of late complications. The occurrence of lymphocele in our cohort was always associated with systemic pelvic and lumbo‐aortic lymphadenectomy, which is in line with current literature . The different approaches to the prophylaxis of lymphoceles (careful hemostasis and lymphostasis using coagulation and clips, application of hemostatic preparations, opened peritoneum after lymphadenectomy) have so far exhibited inconclusive outcomes .…”

Results of a multicenter phase I dose-finding trial of hyperthermic intraperitoneal cisplatin after neoadjuvant chemotherapy and complete cytoreductive surgery and followed by maintenance bevacizumab in initially unresectable ovarian cancer

“…Regarding other toxicities after CCRS + HIPEC, we observed a low incidence of major morbidities: resurgery in 2 patients (6%, versus 8% in the series reported by Bakrin et al) and radiologic drainage of lymphoceles in 6 (20%, versus 27% in the largest series in the literature focused on this topic) [17,21].…”