The insolvable problem; survival effect of lymphadenectomy in advanced stage ovarian cancer

Bakır, Mehmet; Birge, Özer; Karadağ, Ceyda; Doğan, Selen; Tuncer, Hasan Aykut; Şimşek, Tayup

doi:10.5603/gp.a2021.0073

Cited by 1 publication

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“…Systematic pelvic and paraaortic lymphadenectomy is a common procedure in ovarian cancer and a major component of the surgical staging procedure (Video 1). In the literature, the rate of metastatic lymph nodes ranges between 30 and 75% in advanced-stage ovarian cancer [9,12,[21][22][23][24].…”

Section: Pelvic and Paraaortic Lymphadenectomymentioning

confidence: 99%

Management of nodal disease in advanced-stage ovarian cancer: porta hepatis, celiac, pelvic and paraaortic lymphadenectomy

2022

EJGO

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Maximal cytoreduction is considered the most important prognostic factor for ovarian cancer survival. Most ovarian cancer patients are diagnosed at an advanced stage, and more than half of them have upper abdominal involvement. Upper abdominal regions alongside the pelvis should be evaluated systematically as a routine procedure during cytoreductive surgery. Therefore, aggressive procedures are adopted during cytoreductive surgery, including upper abdominal regions, to achieve maximal cytoreduction. It should include the exploration of porta hepatis and celiac lymph nodes. The feasibility of metastatic disease resection at the porta hepatis and celiac lymph nodes has been demonstrated in many studies with acceptable morbidity. Furthermore, ovarian cancer often leads to retroperitoneal lymph nodes metastases in patients with advanced stages of the disease. Data from the literature showed that more than half of the advanced-stage ovarian cancer patients had lymph node involvement. In this manuscript, we reviewed the current literature and aimed to investigate the impact on survival of surgical resection of porta hepatis, celiac regions, and pelvic/paraaortic lymph nodes in patients with advanced-stage ovarian cancer. Resection of metastatic disease at the porta hepatis/celiac lymph nodes to achieve maximal cytoreduction is feasible but with a relatively high rate of morbidity and mortality. Randomized controlled trials indicate that in the absence of suspicious lymph nodes, both during surgery and at imaging, systematic lymphadenectomy seems to provide no survival benefit.

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Section: Pelvic and Paraaortic Lymphadenectomymentioning

confidence: 99%

Management of nodal disease in advanced-stage ovarian cancer: porta hepatis, celiac, pelvic and paraaortic lymphadenectomy

2022

EJGO

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The insolvable problem; survival effect of lymphadenectomy in advanced stage ovarian cancer

Abstract: This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Ginekologia Polska" are listed in PubMed.

Cited by 1 publication

References 24 publications

Management of nodal disease in advanced-stage ovarian cancer: porta hepatis, celiac, pelvic and paraaortic lymphadenectomy

Management of nodal disease in advanced-stage ovarian cancer: porta hepatis, celiac, pelvic and paraaortic lymphadenectomy

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